Letter from WHO "Tobacco free initiative" representative in last week's New Scientist.

[yvilla]

Doesn't the nicotine in the e-cigarette product come from tobbacco? Making it a tobbacco product? The supreme court already ruled against the FDA from trying to gain control over tobbacco products. This is how I would market the product.

That is precisely the issue we have been talking about here for a long time now, Simpson. The FDA claims ecigs are drug devices, maybe because of the bad apples who did market them with health or smoking cessation claims, but now seems to claim that about all ecigs.

Many of us have argued here that that is wrong, that ecigs are just alternatives to tobacco cigarettes and that they should not be categorized as drugs under the jurisdiction of the FDA.

And now Smoking Everywhere has raised that very issue in its suit against the FDA over the blocking of its shipments. They are arguing essentially just what you said, that ecigs are the functional equivalent of cigarettes, only without the actual tobacco, and therefore not subject to FDA authority. Here is their complaint:

http://ronbenvenisti.com/SEFDA1.pdf

However, all the talk about the tobacco bill being voted on soon in the Senate is because it will, if approved as written, give control of all tobacco products over to the FDA. And unless the new legislation is amended to specifically encourage and make lawful the availabilty of ecigs (and other new harm reduction products), is is expected that it may mean the death knell for them via the FDA.

 

[Simpson]

Gives the control over to the FDA, I forgot about that. Phillip Morris is backing this bill in part because the Government made comprimises that included not banning tobbacco products. The FDA plans to limit tobbacco products flavors, I think only menthal will be allowed for cigarettes but I was left to wonder about cigars. They thought by limiting the candy flavors that would discourage kids from starting smoking. Now that I started vaping, I wonder whether the flavors will be controlled also (though 0 nic eliquids I would argue shouldnt be regulated). Thanks for replying to my post, nicely done. I don't expect that my ideas are new, but theyve been on my mind alot, I hope I can further the cause with my occational rants lol.

 

[leaford]

Willpower, the risks of smokeless tobacco have been grossly exaggerated by the anti-tobacco lobbies. It is an excellent example of how their ideological bias affects their research. I'm on vacation right now, and don't have all my bookmarks so I can't find the presentation I normally refer to about that, but here's one study backing me up on this: Evidence-Based Dentistry - Abstract of article: Oral cancer risk and smokeless tobacco products - clouded by smoke?

Basically, the early studies on smokeless tobacco were done in an isolated population, and found a high association. But later studies among general populations have found weak, if any, association between smokeless tobacco and oral cancers. But the anti-tobacco lobby contiues to use the earlier, flawed, data because it serves their interests.

Edit: I found it; this is a pdf presentation about smokeless tobacco as a harm redxuction tool, by anti-smoking activist and scientist, Dr. Carl V. Phillips: http://www.tobaccoharmreduction.org/papers/phillips-harmreductiontalk-slides-nov05.pdf

 

[WillPower]

Doesn't the nicotine in the e-cigarette product come from tobbacco? Making it a tobbacco product? The supreme court already ruled against the FDA from trying to gain control over tobbacco products. This is how I would market the product. There is a urge to claim the product is safer or healthier but we can't make unstantuated claims or the FDA will step in. I suppose we can state the product doesn't burn the tobbacco and therefore doesn't have those health risks associated with that. And studies can be done that show that removing tobbacco leaves prevents users from getting oral cancer like chewing tobbacco. Lastly, this product allows consumers to reduce their nicotine intake down to zero, can other tobbacco products claim that? Eventually they can bring the ecigarette to market as a cease-smoking product after they do years of studies that the FDA would require before approving. The only thing that I may derail this product now is that the nicotine cartridges can be opened/spilled and same with eliquid- I'd like to see manufacturers make them so cant be opened and different way to refill them- hopefully not involving a pharmacy.

There is a quite interesting story behind this (Waxman and SE lawsuit). In the mid-90's, FDA and many good people began to realize that tobacco and chewing tobacco had been killing Americans at the rate of genocidal sociopath, not even Osama Bin Laden, surpassing Hitler. Tobacco and chewing tobacco companies were knowingly contributing to this mass-murder of Americans. Among many things, these companies were found to be manipulating the nicotine level in cigarette and chewing tobacco, in essence "spraying" nicotine over tobacco to make sure that people are addicted and make it difficult to quit.

So FDA said Hell No. If you add nicotine to tobacco, tobacco is a nicotine delivery device. The tobacco exception of FDA jurisdiction doesn't mean you can spray anything on top and get away with it (especially when you are killing children).

In 2000, the Supreme Court, however, saw a problem interpreting the legistrative intent. Because Congress passed several bills regulating tobacco, the Supreme Court interpret this as Congress didn't intend FDA to regulate tobacco. Not resounding victory 5-4, but certainly enough as a stay of execution for tobacco and chewing tobacco companies.

However since then, a lot of other information surfaced. For example, several reputable logitudinal studies confirmed and reconfirmed that tobacco companies are indeed increasing nicotine levels about 2% a year. In other words, in the past 10 years, the nicotine level in cigarettes has risen steadily every year to about 15-20%.

And there is this "light" and "ultralight" scam the tobacco companies did to boost their sales, which is I believe under litigation by FTC.

And also there is the CDC data and other surveys showing chewing tobacco is targeting underaged kids.

And there is the Internet Cig Sales facilitating underage smoking--tobacco companies were fighting tooth and nail on this.

So after all that, Waxman said enough is enough. We will make the legistrative intent crystal clear to FDA and the Court. FDA is in charge. Waxman passed House by super-majority, I believe.

It is expected to pass the Senate too. It remains to be seen. Personally, I doubt what Godshall, some of the people here misled by him, or those who really behind his cause would make any difference. There are literally millions of angry Americans on the side of fence. if you have any doubt about the political resolve of these people, just go and buy a pack of cigarette. Do you really think you will be paying $8-9 per pack, if pro-tobacco people have any chance to winning this battle?

I don't know about you. But when your product is killing well over 400,000 Americans a year, you manipulate nicotine levels, target children, and other crummy things to boost your sales? It just doesn't sit well with me.

SE lawsuit is an uphill battle. First, e-cigs do not have a single tobacco leaf. It is a stretch to apply the 2000 ruling, FDA v. Williamson. Let's say they win. Now what? A court of confident jurisdiction just declare that your product is tobacco product. Doesn't this mean all tobacco regulations now apply to SE? You need tobacco permit to sell SE? Pay tobacco tax? Fine and possibly jail terms for selling to minor?

Besides, if and WHEN waxman passes, their TRO becomes moot. FDA gets the regulatory power over e-cig anyway.

 

[jigtg]

Lets keep in mind that this is still e-cigarette-forum.com not smokefree-tobacco-forum.com . I think theres a tiny weeny bit of difference there.

 

[OutWest]

I dont think internet sales are facillitating teen smoking. After all, they can often just walk into stores and buy them. They said on the news last night that during a recent check in Oklahoma, 18% of retailers sold tobacco to minors. During a check last year in Thurston County, Washington, 19% of retailers sold tobacco to minors Retailers sell tobacco to minors in Thurston County check - Breaking News - The Olympian - Olympia, Washington Not to mention the parents that buy tobacco products for their kids and not to mention the kids that simply shoplift their cigarettes or steal them from their parents or other family members. Why would kids mess with buying online when they can get locally or even from their own parents?

And I dont believe the claims that chewing tobacco is targeting underage kids. I sure havent seen signs of it. Nor did I notice signs of it when I was a kid.

 

[WillPower]

Willpower, the risks of smokeless tobacco have been grossly exaggerated by the anti-tobacco lobbies. It is an excellent example of how their ideological bias affects their research. I'm on vacation right now, and don't have all my bookmarks so I can't find the presentation I normally refer to about that, but here's one study backing me up on this: Evidence-Based Dentistry - Abstract of article: Oral cancer risk and smokeless tobacco products - clouded by smoke?

Basically, the early studies on smokeless tobacco were done in an isolated population, and found a high association. But later studies among general populations have found weak, if any, association between smokeless tobacco and oral cancers. But the anti-tobacco lobby contiues to use the earlier, flawed, data because it serves their interests.

Edit: I found it; this is a pdf presentation about smokeless tobacco as a harm redxuction tool, by anti-smoking activist and scientist, Dr. Carl V. Phillips: http://www.tobaccoharmreduction.org/papers/phillips-harmreductiontalk-slides-nov05.pdf

The first reference you provided me was done by a person who works for Phillip Moris. I couldn't access the full text article (sorry, didn't want to pay $32!). The second reference is a presentation, not journal article. It does not have any reference list. So I can't get the source articles that they are referring to. In addition, it appears that their study (the presentation thereof) is funded by US Smokeless Tobacco Company.

Do you have any journal articles in mainstream "reputable" academic research journals (maybe Journal of AMA, New England Journal of Medicine)?

Here is a rundown on corporate sponsored research (which I have done many times in my career). One of two ways. First, they fund you and you need to sign a non-disclosure agreement (NDA). You can't publish anything without their approval. Second, you complete a research project and, if they like the findings, they fund you with unrestricted grant.

They do this for a good reason (that is, good for them). Every scientific research has statistical weakness. At the p-value = .05 level, 1 out 20 studies would have "false positive" findings (finding something where there is nothing in reality). There is also statistical error that you find nothing where something is there. Statistical power at, say, .80 or .90, means about 1 out of 5 or 10. this error would occur. Power depends on sample size, effect size, etc.

That means, even if the researchers do honest, no falsification studies, 1 out of 10 or 20 studies, a corporate would get exact what they want, no matter what the "truth" is. In other words, in the worst possible cases, they can suppress 9 or 19 studies, they would get the publication they want. They do provide you an incentive to get the results they want without going through 19 studies.

Grants from National Institute of Health or National Science Foundation do not have this NDA requirement. In fact, you are required to publish no matter what the findings are. Department of Defense, NSA, etc. have different kind of NDA (no matter what the findings are, you publish, you go to jail for Treason, if they don't kill you first ).

I don't know much about UK, but in the US, "reputable" AE or the editorial board will send their manuscripts to reviewers both sides of the fence (including "hostile", if you will). I am using the term "reputable" not in the colloquial usage, but can safely say that JAMA is and Harm Reduction Journal isn't.

Overall, I would say the "risk" of chewing tobacco should be quite obvious.. Just do a Google search on chewing tobacco and health risk or mouth cancer. You will find many articles and PICTURES, including the position of medical establishments such as National Cancer Institute, American Cancer Society, American Medical Association, and many large healthsystems like Mayo Clinics, etc.

 

[katink]

Damn - missed an important NOT out - corrected in the above

Guess it was a rather important 'not' indeed... but it's quite clear now; and lets hope they are not picking anti's to do peer-reviews... it sure would be a way to get the NZ-studies discredited...

Welcome aboard btw; glad to see you join us. What is your field of interest, if I may ask?

 

[WillPower]

I dont think internet sales are facillitating teen smoking. After all, they can often just walk into stores and buy them. They said on the news last night that during a recent check in Oklahoma, 18% of retailers sold tobacco to minors. During a check last year in Thurston County, Washington, 19% of retailers sold tobacco to minors Retailers sell tobacco to minors in Thurston County check - Breaking News - The Olympian - Olympia, Washington Not to mention the parents that buy tobacco products for their kids and not to mention the kids that simply shoplift their cigarettes or steal them from their parents or other family members. Why would kids mess with buying online when they can get locally or even from their own parents?

And I dont believe the claims that chewing tobacco is targeting underage kids. I sure havent seen signs of it. Nor did I notice signs of it when I was a kid.

Believe or not, that 19% is a big improvement. It used to be almost 100% and virtually no enforcement. One of the reasons that FDA was having a cow during the 90's, which led to FDA v. Brown Williamson decision.

It turns out that many youngsters don't want to go through the hassle of finding 1 out of 5 stores that sells to kids nor bother with shoplifting. What I can say? Kids these days.

A few reputable studies showed kids (not a small number) are buying cigs through Internet (of course there is this state tobacco tax evasion too). In the past few years, Attorney Generals of many states (most of 50 states) and ATF have been working on stopping this. Interesting development, but haven't followed up much myself.

CDC data on chewing tobacco use is quite extensive (substantial sample). I should clarify the data showed widespread use of chewing tobacco among kids. Chewing tobacco "targeting" kids are a very common interpretation of this data among experts and practitioners. Wide spread use + adverting in sports and music events and other "inappropriate" advertising, etc.

According to CDC the usage is quite high, enough to rais many eyebrows. In addition, they found that these kids who use chewing tobacco are more likely to start smoking too--talk about harm acceleration! Go figure..

 

[skex]

According to CDC the usage is quite high, enough to rais many eyebrows. In addition, they found that these kids who use chewing tobacco are more likely to start smoking too--talk about harm acceleration! Go figure..

I'm not quite ready to comment on the rest but this strikes me as bluring the lines of causation and correlation. It seems to me that the kids most likely to use chewing tobacco tend to be the types of kids/people who are most likely to engage in risky behavior in general. In fact I'd be interested in seeing how this data stacks up when comparing other risky activities such as drinking, reckless driving and other drug use.

THe assertion just seems as shady to me as the assertions that Marijuana is a gateway drug.

Another question I'd have about the data on smokeless tobaccos, is there any difference in the health affects of snus and other desolvable's as compared to snuff and chewing tobacco? After all we know that beyond the byproducts of combustion that there are other chemicals involved in tobacco that are carcinigenic.

 

[yvilla]

Another question I'd have about the data on smokeless tobaccos, is there any difference in the health affects of snus and other desolvable's as compared to snuff and chewing tobacco? After all we know that beyond the byproducts of combustion that there are other chemicals involved in tobacco that are carcinigenic.

Here you are referring to tobacco specific nitrosamines. And yes, there is plenty of data showing that snus have less nitrosamines, and that is why they are less dangerous than chewing tobacco.

I've go to run now so can't post any specific links, but I believe some of that data/those studies on the relative risks of various smokeless products can be found through:

Tobaccoharmreduction.org

 

[TropicalBob]

Chew is a high-risk, filfthy product and requires regular spitting. The high TSNA tobacco sometimes initiates mouth cancer and is highly destructive to teeth and gums. It is also considered by many to be as addictive as cigarettes. A disgusting product that becomes a disgusting habit. Avoid at all costs!

Snus have more than a century of use to study in Sweden. As for cancer, Sweden has the lowest overall rate in the EU. Many smokers have switched to snus in that country, so data is plentiful. The processing of the tobacco is vastly different from "chew", so the two don't compare. And "purified" snus have extremely low TSNAs. I use those. No mouth harm has been reported.

Nasal snuff has the longest history of all. Not one cancer reported. Not many people still practice sniffing, but its history indicates it is a safe source of nicotine.

Dissolvables are too new to have a history, but my Stonewall dissolvables have a TSNA count lower than even the best snus. They are purified, ground Virginia tobacco with flavoring and sweetener added. They're very easy to take first thing in the morning with coffee.

There are a plethora of reports and tests on the older tobacco products. Plenty of science on the new dissolvables. All smokeless products like these are provably less harmful than inhaling cigarette smoke and do NOT deserve a warning that they are not a less harmful alternative to smoking. That's Health-Nazi BS and undermines truthful harm warnings on tobacco products.

Avoid only chew. It's in a dirty class all its own.

 

[SharonLM]

Great information, thanks so much for the links and the reports!

 

[leaford]

The first reference you provided me was done by a person who works for Phillip Moris. I couldn't access the full text article (sorry, didn't want to pay $32!).

The second reference is a presentation, not journal article. It does not have any reference list. So I can't get the source articles that they are referring to. In addition, it appears that their study (the presentation thereof) is funded by US Smokeless Tobacco Company.

Do you have any journal articles in mainstream "reputable" academic research journals (maybe Journal of AMA, New England Journal of Medicine)?

Well, I DID say it was a presentation, didn't I? But, yeah, that was a bare bones version, sorry. Here's a fuller version with all references cited on the last page. http://www.epiphi.com/papers/phillips-wang-guenzel_curioushistory_poster.pdf

The author, Carl V. Phillips DOES recieve SOME funding from a Smokeless Tobacco company, but under a non-interferance clause, not an NDA clause. He is a respected epidemiologist, at the University of Alberta, with lots of publications to his name, not a one-horse pony or tobacco shill.
http://en.scientificcommons.org/carl_v_phillips


And as for that abstract, sorry, unless you subscribe that's all you can find on the internet, abstracts or summaries. And the author may be funded by PM, but that doesn’t invalidate his work in itself, unless you can point out a flaw in the science. But here’s a couple more, which definitely don’t have a pro-tobacco bias: The relative risks of a low-nitrosamine smokeless ...[Cancer Epidemiol Biomarkers Prev. 2004] - PubMed Result

Smokeless tobacco and cancer. [Lancet Oncol. 2008] - PubMed Result

The first finds that the risk of oral cancer from smokeless tobacco is only 15%-30% that of smoking, and concludes that “The risks of using LN-SLT products therefore should not be portrayed as comparable with those of smoking cigarettes as has been the practice of some governmental and public health authorities in the past.” The second finds that chewing tobacco only accounts for 4% of all oral cancers. It’s been estimated that 6% of Americans chew, and up to 30% in some areas. But that only accounts for 4% of oral cancers? That’s a pretty weak association, IMO.

But requiring citations cuts both ways, Dude. Can you cite for me a study showing that smokeless tobacco has a greater risk than smoking for oral cancer? Or is in any other way NOT less harmfull than smoking? Because that's what harm reduction is all about. Just because it's not perfectly safe doesn't mean it's not safer.

 

[prof beard]

Guess it was a rather important 'not' indeed... but it's quite clear now; and lets hope they are not picking anti's to do peer-reviews... it sure would be a way to get the NZ-studies discredited...

Welcome aboard btw; glad to see you join us. What is your field of interest, if I may ask?

Thanks for the welcome. My field is the use of technology in learning (My team and I do a mix of technology, educational theory and policy). I'm a computer scientist who decide people were more interesting

I don't suffer from problems of "bias" in my own field, but have come across cases in other areas where people have had problems getting "inconvenient" papers published, and areas where those following "inconvenient" lines of research have had trouble getting/getting funding (in various countries I should add). An example (please note I not saying I agree or disagree the people in question) is in the area of climate change research...

 

[Kate51]

Some heavy, mind and eye opening information.
So many hurdles, coming down first to getting the FDA to not be in control of the tobacco products.

More letters must go!

 

[Smokingfreely]

Bill, you are really something. FDA and Waxman are protecting cigs? Now WHO is with pharma? Waxman is protecting cigs, so we should go with Senator Burr -- the gentlemen from Winston-Salem, right?

Maybe, WHO is not responding you, because they don't like the chewing tobacco you are peddling. Chewing tobacco is NOT a safe alternative to cigs (all US medical establishments, American Cancer Society, National Cancer Institute, etc agree on this). Not only Godshall's chewing tobacco cause oral cancer and other ailments, but also in the US, chewing tobacco is heavily marketed to children (most under-aged users begin at 6-9 grades!). A large portion of chewing tobacco users later become cig-smoker! Talk about harm acceleration!

Waxman's bill has a stronger restriction on "harm reduction" tobacco products. These restrictions are there because big cig companies are misleading consumers with their "light" and "ultralight" cigarettes, making them thinking they are safer. That's why cigs AND chewing tobacco people want Waxman defeated.

These "harm reduction" tobacco products are really dangerous, in practice a lot more dangerous than real cigs due to how they are marketed, such as targeting kids and mislead people to think they are safe.

Godshall wants us to join in this category. Wouldn't it be nice for tobacco and chewing tobacco to stand next to something that actually didn't kill anyone yet? But for us? It's like having a child-molesting serial killer as a running mate in an election.

Fortunately (excuse my expression here - I know I shouldn't say "fortunately"), these cigs and chewing tobacco have killed and hurt enough people, ruined enough families, and given insufferable pain to enough parents, there is almost no chance that pro-tobacco (and pro-chewing tobacco) Burr provisions are going to pass instead of Waxman or Kennedy nor make their way into Waxman.

I too don't want to waste my breathe on Bill's propaganda. However, I just hate to see good people in this forum, manipulated into doing something they wouldn't do only if they had known.

Yet another post of drivel and misinformation.

First, to your assertion that lights and ultralights are not safer - for once I agree with you on something, they are actually worse because they have a higher ratio of tar and other harmfull chemicals to niccotine. And that is an excellent reason NOT to support the Waxman legislation that would give the FDA the right to control (most likely eventually lower) the niccotine levels in cigarettes.

Secondly to your comments on the marketing of smokeless tobacco - kids??? Seriously!?! You think little Johnny thinks dipping's cool? Show me a single example of dip, snus, snuff etc. being marketed to kids. All the naysayers like to use these ridicluous hot-button phrases such as "marketed to kids," well back it up with SOMETHING at least.

Lastly, there is certainly NOT a consensus that smokless tobacco is just as harmfull. There are a plethora of solid articles published by reliable medical journals (just do a quick search on pubmed if you don't believe me) that assert that smokeless is less harmfull - it's a given really. See this article from The American Council on Science and Health on the matter. http://www.acsh.org/healthissues/newsID.744/healthissue_detail.asp