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Turkey’s president likens quitting smoking to rebirth

| March 9, 2015

Turkey’s President Recep Tayyip Erdoğan has made yet another attempt to fight tobacco smoking by saying that a social landscape should be created to put pressure on smokers, according to a story in the Hurriyet Daily News.

“We must create a social landscape where smokers are condemned,” he was quoted as saying.

“When I see someone smoking, I try my best to take their packets from them. I feel happy when I make someone quit smoking, as if I have helped their rebirth,” Erdoğan said at a Green Crescent Society (Yeşilay) event in Istanbul last week.

The president, who has often spoken out against smoking, mentioned that until 2008 it was legal to smoke everywhere in Turkey, including on airplanes and trains, and even at sports centers. The government then passed a law banning smoking indoors.

In addition to fighting the smoking habit, Erdoğan claimed responsibility also for fighting against other habits, such as drugs and alcohol.

Yeşilay, which is an organization that endeavors to fight ‘harmful habits’, recently created a stir when, in an attempt to attract more government funding, it added ‘prostitution, technology and gambling’ to its list of harmful habits.

Yeşilay has traditionally restricted its work to the struggle against tobacco, alcohol and drug addiction.

Smokers cut from some operations in England

| March 9, 2015

Clinical Commissioning Groups (CCG) in England are denying medical treatments to high numbers of people who are obese or smokers, according to a story by David Millett for GP Magazine.
Eighty three percent of CCGs restrict access to surgery and treatments based on a patient’s BMI [body mass index], and at least one blocks all routine surgery for obese patients unless they lose weight.

Sixty two percent will not allow patients to receive certain treatments based on their smoking status.

The General Practitioners Committee deputy chairman Dr. Richard Vautrey condemned the “rationing of services” as unfair, unethical and unacceptable. He said CCGs hid behind “spurious clinical reasons” to discriminate against some groups to cut costs.

One CCG was quoted as saying that, given the limited resources available to the National Health Service, the CCG considered it would not be appropriate for some treatments to be routinely available to all patients.

Another said it applied restrictions to ‘ensure that limited resources available to the CCG are applied to those with most health need’.

More than 100 CCGs would only allow non-smokers to access fertility treatments and IVF. Many said their decision was underpinned by NICE (National Institute for Health and Care Excellence) guidance, but the guidance recommends only that patients ‘should be informed that smoking is likely to reduce their fertility’, not that they should be denied treatment.

“It’s blatant rationing,” said Vautrey. “CCGs should be open and honest. If we’re going to ration a service we should ration it for all people, not just those in particular groups and pretend it’s for clinical reasons.”

Big cigars light up another US tobacco battle

| March 9, 2015

The American Academy of Family Physicians (AAFP) has expressed its strong opposition to a bill that would exempt ‘traditional large and premium cigars’ from regulation by the Food and Drug Administration under the Family Smoking Prevention and Tobacco Control Act, according to an American Family Physician story.

The bill would reportedly amend the Federal Food, Drug and Cosmetic Act to exempt from FDA oversight certain cigars, including some machine-made products that retail for $1. It could allow also some flavored cigars to qualify for exemption.

‘No tobacco product should be exempt from regulation – and certainly not inexpensive and flavored cigars,’ said a February 25 letter that was written by the Campaign for Tobacco-Free Kids (CTFK) and signed by about 30 health care and public health-related organizations, including the AAFP.

‘Tobacco manufacturers have a history of modifying their products to avoid public health protections or attain lower tax rates.

‘We are concerned that the number of cigars covered by H.R. 662 [the bill in question] would increase over time as cigar manufacturers modify their products or change their manufacturing processes to qualify for the exemption.’

The bill is awaiting review by the House Energy and Commerce Committee’s Subcommittee on Health.

A Senate companion bill was referred to the Committee on Health, Education, Labor and Pensions.

‘E-cigarettes lead to tobacco cessation, not initiation’

| March 6, 2015

Two new United States surveys have found that 15-21 million U.S. adults used e-cigarettes regularly in 2013-2014; 3.2-4.3 million e-cigarette users no longer smoked cigarettes on a regular basis; and approximately 90 percent of regular e-cigarette users were/are regular cigarette smokers. The studies—which were presented in Philadelphia, Pennsylvania, USA, from Feb. 25-28 at the annual meeting of the Society for Research on Nicotine and Tobacco—lead their authors to note that regular cigarette smokers were more likely to switch to regular use of less-harmful e-cigarettes than regular e-cigarette users were to transition to combustible cigarette use.

The first study analyzed 30,136 people from the National Tobacco Behavior Monitor survey. Results indicated that 8.7 percent of U.S. adults reported regular use of e-cigarettes, of which nearly 90 percent reported regular use of combustible cigarettes. More than 97 percent of those surveyed in the first study reported regular e-cigarette use after regular cigarette smoking; 23.7 percent indicated that they no longer use combustible cigarettes on a regular basis; and only 1.3 percent of those who use e-cigarettes regularly reported transitioning to current regular use of combustible cigarettes.

The second study—which analyzed data from the Total Tobacco Migration Tracker—involved 11,173 people and indicated that 6.1 percent of U.S. adults identified themselves as current, regular e-cigarette users, with more than 91 percent of those e-cigarette users reporting regular use of combustible cigarettes. More than 97 percent reported regular use of e-cigarettes after regular use of combustible cigarettes; 24.5 percent of those who regularly used e-cigarettes no longer reported regular smoking of traditional cigarettes; and only 1.7 percent of current, regular e-cigarette users reported switching to regular use of combustible cigarettes.

The results of this study lead its authors to determine that smokers of traditional cigarettes were 13.5 times more likely to transition to current, regular use of e-cigarettes than current, regular users of e-cigarettes were to transition to regular use of combustible cigarettes.

The studies were funded by RAI Services Co. and conducted by a team led by the company’s senior director of regulatory oversight, Geoffrey Curtin.

Califf appointed deputy commissioner of FDA

| March 6, 2015

Robert Califf, a cardiologist and researcher at Duke University in Durham, North Carolina, USA, was appointed as the U.S. Food and Drug Administration’s (FDA) deputy commissioner for medical products and tobacco on March 2. Califf—who was previously overseeing the FDA’s drug, medical device and tobacco policy—is a recognized global leader in cardiology, clinical research and medical economics, according to the FDA. He was appointed by FDA Commissioner Margaret A. Hamburg, who will leave the organization at the end of March, leading to speculation that Califf may be nominated to lead the FDA following her departure.

In his new role as deputy commissioner, Califf will provide executive leadership to the Center for Drug Evaluation and Research, the Center for Tobacco Products, the Center for Biologics Evaluation and Research, and the Center for Devices and Radiological Health. His duties will include providing policy direction and advice on the FDA’s medical product and tobacco priorities, and he will manage clinical, scientific and regulatory initiatives in areas ranging from pediatric science and personalized medicine to orphan drugs and the advisory committee system.

Califf previously served as vice chancellor of clinical and transnational research at Duke University, professor of medicine at Duke University Medical Center’s Division of Cardiology, director of the Duke Transnational Medicine Institute and founding director of the Duke Clinical Research Institute, the world’s largest academic research organization. The Institute for Scientific Information has recognized Califf as one of the top 10 most-cited medical authors due to his more than 1,200 peer-reviewed publications.

Cigarette smoke releases more toxins than e-cigs, study says

| March 6, 2015

A study examining the vapor released from Blu Ecigs’ and Skycig’s e-cigarettes in comparison to the smoke emitted by Philip Morris USA’s Marlboro Gold and Imperial Tobacco’s Lambert & Butler cigarettes found that levels of harmful and potentially harmful constituents (HPHCs) in cigarette smoke were 1,500 times higher than the levels found in e-cigarette vapor.

The study—titled “Comparison of select analytes in aerosol from e-cigarettes with smoke from conventional cigarettes and with ambient air”—was published in the December 2014 issue of Regulatory Toxicology and Pharmacology. According to proponents of vapor product use, the study lends credence to the belief that, although the long-term effects of inhaling the propylene glycol and glycerin found in e-cigarette vapor are not yet known, such products provide a safer alternative to smoking combustible cigarettes.

According to the study, the e-cigarettes tested contained and delivered mostly glycerin and/or propylene glycol and water, and emitted an aerosol nicotine content that was 85 percent lower than the cigarette smoke nicotine content levels. The study also found the levels of HPHCs to be consistent with the air blanks—at <2 μg/puff—and no significant contribution of tested HPHC classes was found for the e-cigarettes tested. The e-cigarettes and combustible cigarettes in the study were tested on a smoking machine to compare the amount of nicotine delivery and the relative yields of chemical constituents.

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