The Network

for LGBT Tobacco Control

SRNT Update 3: Means to and ENDS

An interesting discussion emerged from Dr. Nathan Cobb’s presentation on E-cigarettes.  First and foremost, he asked, they not be called E-cigarettes, because it implies it is from tobacco, which E-cigs don’t contain tobacco.  Rather, they are Electronic Nicotine Delivery System, or ENDS for short.  In my own home state some people are looking towards ENDS as a cessation mechanism, and to that I would say “not so fast” after seeing Dr. Cobb’s presentation.

While ENDS would potentially be a safe way to deliver nicotine (although Nicotine itself is still not considered a safe substance), trace amounts of Tobacco-specific N-nitrosamines were found in some of the products tested by the FDA along with acetaldehyde, acetone, and formaldehyde.  What’s more scary is that different chemicals were found not just with differing brands but also even within the same brand.  There were also inconsistencies in the amount of nicotine in each puff, even within the same brand, and varied within the same cartridge from puff to puff.  Last, the level of nicotine in the blood was very low and didn’t do much to reduce urges in smokers.

That means that ENDS would not be a good cessation device even just for its nicotine delivery properties.  But that’s not the only danger.  Think about this: you’re helping your friend quit, and everything is going perfectly, then she says “Oh, I don’t have to worry about quitting anymore ‘cause there’s these electric cigarettes that are safe”.  Her motivation just went out the window, and you may have to work double time to get her into the preparation or action stage of quitting.  Because ENDS are bad for notice delivery chances smokers will relapse because they’re not getting the needed nicotine in their blood system.  So not only does it have the potential to screw with someone’s self-efficacy to quit but also may be setting them up for failure because of the low nicotine levels it delivers.

But consider this: snus on the other hand does deliver an adequate amount of nicotine but in some cases is less than half as dangerous than smoking, that’s according to the presentation by Dr. Lois Biener.  Here’s the danger, as she presented: tobacco companies are not marketing snus as a harm reduction approach, rather as an addition to smoking.  A Marlboro snus add Dr. Biener showed us clearly showed Marlboro trying to brand snus as another way smokers can get a nicotine fix, perhaps in the face of new bans around the country?  Can’t smoke in the job?  Just pick up a pack of snus and feel good until the next time you smoke.  It could also be a way to undermine a smoker’s quit attempt.  Most smokers WILL quit cold turkey, even though it may not be the least painful way.  Is this a way for Marlboro to get in the middle of someone who wants to quit smoking by creating a middle step between an ex-smoker and a current one?  With Marlboro deciding your quit plan I would venture to say you’re probably not going to quit for good.

But seriously, what if snus was remarketed and was aimed a people who wanted to quit smoking as a nicotine delivery aid?  While snus is definitely NOT safe, the difference in deadly risks between smoking and snus is large.  Will the tobacco field ever go into the realm of other public health disciplines that utilize harm reduction techniques?  What do you think?

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February 25, 2010 Posted by | Scholarship Opportunity | , , | Leave a comment

SRNT Update 2: The Power of Communications

During the first Paper Sessions at the SRNT conference, there were a few things that stuck with me.  Here’s a quick rundown

Culture and Communications…

Back in Hawaii there is a small movement to stop segregating data by ethnicity.  You see, in Hawaii it’s hard to find someone who’s just one thing, usually most people are mixed with something.  So where do you classify them?  In the Japanese, in the Native Hawaiian, or the White column?  Usually they classify themselves, but the problem is still if we’re presenting data for a specific ethnicity what we really are presenting is people have at least that one ethnicity.  In any case, Dr. Monica Webb from the University of Miami had a good presentation on the power of culturally specific versus standard health education messages and materials.  In her randomized study, they placed African-Americans into two categories: one who received messages and materials specifically tailored to African-American and another who received standard materials.  The results showed that those in the culturally tailored intervention showed a higher readiness to quit, had more knowledge about tobacco overall, and had higher perceptions that African-Americans are at greater risk for tobacco use.  This is important, because it shows that culturally relevant materials do work.  However, in the issue of Hawaii, or for millions of highly acculturated immigrants, which culture do you target them through?

Speaking of culture and tobacco, the Dept. of Health in New Zealand presented on the difference between using text-based warning messages on packs versus using graphic messages.  What they found was that Maori people were most impacted by the graphic messages.

The Color Scheme

Dr. Maansi Bansal-Travers from the Roswell Park Cancer Institute presented a fascinating look into how important color is to cigarette packs.  In her study, they recruited smokers via Craigslist *giggle* to assign a description to a box of well-known and not very well know cigarettes.  The description that came with the box, such as “lights” or “ultra mild” were removed.  For the most part, the smokers were able to identify which ones were “light” and such based solely on the color of the packs.  Even more interesting is that the smokers then said that if they were worried about their health or wanted low-tar cigarettes they would probably pick those they identified as “light”.  SOOOO this means that just removing the label of “light” won’t do anything because the colors already convey the message the tobacco makers want to get across.  I wonder what color the cigarette boxes would have to be to incite the feeling of “puke”…add that to the “things that make you go hmmmm…”

February 25, 2010 Posted by | Scholarship Opportunity | , , | Leave a comment

SNRT Conference Update 1: FDA Tries to Get Tough

During the first session at the Society for Research on Nicotine and Tobacco we heard from Lawrence Deyton, the doc in charge of implementing the Family Smoking Prevention and Tobacco Control Act, which puts the tobacco industry under FDA regulation.

While the beginning of his speech was more of a pep-talk, there were a few interesting bits of info.  One of the not-very-surprising items was that the FDA will have different  standards for tobacco will be different than for the other drugs they review.  Although some of us had wanted the FDA to deem there was no safe level of tobacco use, therefore pull it off the markets, it’s pretty obvious now that FDA will not do that.  FDA will instead act with regulatory actions.

There were 5 Key features of the act he wanted to point out from the policy:

  1. The act mandated ceasing the selling of fruit or other spice-flavored cigarettes – which has already has been implemented. As most of us know, this does not include Menthol, which sucks because menthol tends to be used most in the most disparate populations.
  2. Act requires the creation of a Tobacco Product Scientific Advisory Committee. They will look at things like “the use of menthol with children or minority”  One thing that made me go “YIKES”: Three non-voting members from tobacco companies, including growers.  However, most will be docs. I’m personally afraid that the non-voting members will be some of the best speakers tobacco companies will find.  I used to be a non-voting member on the Board of Education, and while I advocated for voting rights, there’s a great deal of influence that comes with simply sitting on a board of any sort.  And why would FDA want to take any guidance of any tobacco industry people?  Alright, put that on my “does not compute” column.
  3. Establish good manufacturing practices.  But good to who?  Good tobacco marketing practices for the population would be NO marketing.  I have a feeling that they are going for “good for all” type of agreement.  Right, as if tobacco companies need any extra help.
  4. Requires manufactures to report ingredients, including nicotine, and risks in engaging in products.
  5. Authorizes FDA to put larger warning statements on packs (1 of 9) an on smokeless tobacco products (1 of 4). They will be large and have color graphics.  I wonder if there’s a place to look at them?

The doc stated if tobacco companies don’t stay in line, FDA will investigate and ensure compliance. They have already issued 25 letters already.  Yes, you read right, a “letter”,

Finally, the doc ended by saying what they are working on immediately:

  • Reissue the 1996 rule that advertising shouldn’t be to youth
  • Enforce requirement that companies using light low mild must put in applications with FDA. Applications?!  Seriously?  Isn’t there enough data out there to show that these are misleading titles?
  • Will research if certain words, colors, etc. may mistakenly signal that certain tobacco products are safer.  (see my commentary above)

Essentially, at the end the Doc wanted to make sure that we understood that FDA has to follow science and he stated “the success of our efforts will be ultimately determined by the quality of our science.”

He also encouraged for researchers and tobacco control experts around the country to give ideas to FDA through dockets they develop to get community input.  You can find them at http://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/UCM173455

During the question and answer the Doc did made it clear that Nicotine Replacement Therapy will not be regulated by the same group that will regulate tobacco.  NRT will be regulated as a drug delivery. He could not share much about e-cigarettes because there is a pending lawsuit.

For more information about the Family Smoking Prevention and Tobacco Control Act visit http://www.fda.gov/TobaccoProducts/default.htm

February 25, 2010 Posted by | Scholarship Opportunity | , | Leave a comment

   

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