Conclusions of EU's scientists and others on whether e-cigarettes help smokers quit

The Physicians for a Smoke-Free Canada has an excellent compilation and analysis of the evidence on e-cigarettes. Full blog article here: Physicians for a Smoke-Free Canada: Conclusions from the EU's scientists and others on...

This week the European Union's scientific advisers issued their "Final Opinion on Electronic Cigarettes". This report strengthens concerns about the risks associated with e-cigarette use, while failing to find more than weak evidence that they help smokers quit. 

• evidence supporting e-cigarettes as an effective smoking cessation device was "weak". 
• evidence that second-hand exposure to e-cigarette vapour posed risks was "weak to moderate".
• evidence that e-cigarettes helped smokers cut down on the amount smoked was "weak to moderate".
• evidence that e-cigarettes could cause cancer in the respiratory tract was "weak to moderate".
• evidence that e-cigarettes posed risks for coronary disease was "moderate".
• evidence that e-cigarettes were a gateway to smoking for young people was "moderate"
• evidence that e-cigarettes with nicotine were addictive was "strong"
• evidence that flavours in these products contribute to initiation was "strong".

WHO's statement on heated tobacco products and the US FDA decision regarding IQOS is spot on

The full statement is reproduced below and also available on the WHO website: https://www.who.int/news-room/detail/27-07-2020-who-statement-on-heated-tobacco-products-and-the-us-fda-decision-regarding-iqos

WHO statement on heated tobacco products and the US FDA decision regarding IQOS

27 July 2020

WHO takes this opportunity to remind Member States that are Parties to the WHO Framework Convention of Tobacco Control (FCTC) of their obligations under the Convention. Heated tobacco products are tobacco products, meaning that the WHO FCTC fully applies to these products. (Decision FCTC/COP8(22)) Specifically, Article 13.4(a) obliges Parties, to prohibit "all forms of tobacco advertising, promotion and sponsorship that promote a tobacco product by any means that are false, misleading or deceptive or likely to create an erroneous impression about its characteristics, health effects, hazards or emissions."

WHO reiterates that reducing exposure to harmful chemicals in Heated Tobacco Products (HTPs) does not render them harmless, nor does it translate to reduced risk to human health. Indeed, some toxins are present at higher levels in HTP aerosols than in conventional cigarette smoke, and there are some additional toxins present in HTP aerosols that are not present in conventional cigarette smoke. The health implications of exposure to these are unknown.

On 7 July 2020, the US FDA authorized the marketing of a heated tobacco product, the IQOS Tobacco Heating System, under the Federal Food, Drug and Cosmetic Act. This Act requires pre-market authorization of new tobacco products before they can be placed on the US market.

The US FDA statement noted that, “Even with this action, these products are not safe nor “FDA approved“. The exposure modification orders also do not permit the company to make any other modified risk claims or any express or implied statements that convey or could mislead consumers into believing that the products are endorsed or approved by the FDA, or that the FDA deems the products to be safe for use by consumers.”

The US FDA authorization rejected claims that the use of the product is less harmful than another tobacco product or reduces risks to health. The FDA orders also require the company to monitor youth awareness and use of the products to help ensure that the marketing of the MRTPs does not have unintended consequences for youth use. The company must also keep the FDA apprised of efforts to prevent youth access and exposure.

Given that health may be affected by exposure to additional toxins when using HTPs, claims that HTPS reduce exposure to harmful chemicals relative to conventional cigarettes may be misleading.

Moreover, the relevant orders grant a temporary market authorization within the US and are based on factors specific to the US, which is not a Party to the WHO Framework Convention on Tobacco Control (WHO FCTC).

All tobacco products pose risks to health and WHO urges full implementation of the WHO FCTC. Rigorous implementation will support quit attempts and reduce initiation by non-users of tobacco products, especially the young. WHO recommends cessation of all tobacco use with interventions, such as brief advice from health professionals, national toll-free quit lines, nicotine replacement therapies and cessation interventions delivered via mobile text messaging.

MIssion: Smoke-free Philippines

All health-loving Filipinos are encouraged to join the "Mission: Smoke-free Philippines" group on Facebook! Pwede na rin isali ang lahat ng mga kakilala ninyo sa FB.

You may also contact the groups founder, Tony Abundabar, through 0919 826 1895 if you want to do more or provide support. He also has set up a blog at http://missionsmokefree.blogspot.com/.

Magkaisa tayo para sa kalusugan ng lahat. A healthy nation is a wealthy nation.

MMDA is mandated by law to protect public health

Thinking aloud: (my response to someone's blog article, which is copied below)

On top of the annual 5.4 million killed globally by tobacco use, there are at least 600,000 people who die from exposure to second-hand smoke (SHS) each year.

In addition to RA9211, which is the only law being cited by the Philippine Tobacco Institute, the tobacco industry's lobbying arm, the Philippines also has at least 2 other laws that cover smoking:
a. the Clean Air Act, which prohibits smoking in public places, and
b. the Framework Convention on Tobacco Control (FCTC), an international public health treaty to which the Philippines and 173 other countries are Parties.

Based on irrefutable scientific evidence, the World Health Organization recommends that because there is no safe level of exposure to tobacco smoke, only 100% smokefree public places can effectively protect people from such harmful exposure.  This is also the core recommendation contained in the FCTC Article 8 Guidelines to help countries implement their treaty obligations.

For more information on second-hand smoke:
http://dryul.blogspot.com/2010/08/what-is-second-hand-smoke-shs.html

There is also clear scientific evidence that shows how secondhand tobacco smoke, especially indoors, is more harmful and more concentrated than vehicular smoke emissions.

Thus there is very strong legal and scientific basis for both MMDA and the LGUs to develop, implement, and enforce smoking restrictions that will protect Philippine public health.  In fact, the national government also has the same legal and scientific basis to correct the weaknesses and inconsistencies in RA9211 (loopholes created by the tobacco industry) because the FCTC (based on scientific evidence and international best practice) was ratified by the Philippines after RA9211 was signed into law.

It's actually quite terrible that some congressmen give public health the lowest priority in their legislative agenda.  They seem blind to the obvious fact that health is a cornerstone of social and economic development of our people and our country. Of course, some of them are in it more for the power and money rather than to serve the Filipino people.

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Smoking Ban: Boon or Bane?
An article by kinky
http://otra-cosa.com/httpdocs/?p=3171#comment-107

These past few months, May, to be exact; the court has ordered the Metropolitan Manila Development Authority (MMDA) to implement the non smoking ban in Metro Manila, all of its cities and municipalities included.

It is to prohibit smoking of cigarettes in public places. From bus terminals, waiting sheds, schools, hospitals, recreational places and inside public utility vehicles, as they are putting up a campaign to protect Filipinos from secondhand smoke.

Smokers caught violating the public smoking ban will be fined PHP500 for the first offense, PHP 1000 for the second offense and PHP5000 for the succeeding violations. If a person is not able to afford the fine, they are required to serve 8 hours of community service. Frequent violators can also be detained.

The MMDA, however, announced that people can still smoke in designated areas so as not incur charges. Thinking about it, I being a smoker myself make me wonder if it would benefit me. Maybe, but can you really stop these major companies like Marlboro, Winston, Salem, etc. to stop their operations? Being part of the major investors in our country to stop their production? I don’t think so. A lot of people in the Philippines smoke, even our own President. It’s hard to stop this kind of industry.

There are a lot of loose ends on this new ordinance. They are issuing the MMDA to enforce the ban. The MMDA is placed under a “no line agency” and it exists by itself according to Section 29 of this new non smoking law. So technically, MMDA does not have the right to enforce the ordinance. If the Congress wanted to have MMDA implement the ban, they should have included MMDA in the list of implementing agencies in the first place. Also, the Philippine Tobacco Institute (PTI) is arguing that having the major and secondary roads included in this non smoking law is not included in the list of prohibited places according in the RA9211.

Because of these and a few more others, the court issued a temporary restraining order against the smoking ban.

I mean, this new law may benefit almost everyone, definitely not the smokers. But this is already out in the open and people tend to put more effort here than the other factors that have been going on longer than this one. Smoke belching public buses, jeeps and cars, for instance. Isn’t that more hazardous than cigarette smoke? The black smog that those public utility vehicles have been emitting, isn’t that more dangerous than cigarette smoke?

I strongly believe that being in the streets of Manila for 5 minutes does more harm than being a passive smoker for 10 years.

MMDA and the police force should first remove all those smoke belching jeeps, buses, trucks and the likes off the streets first than those cigarette smokers. That’s the only time that Metro Manila will be clean. They should remove the real threats first.

I hope the courts would be able to fix the loopholes in their smoking law. And as a Filipino, I support it even if I am a smoker. But the current state of this law is still shady, so fix this, as it affects everyone. The smokers in particular.