US denies authorization to many vaping products

The US drug regulator on Thursday denied market authorization to a number of vaping products after finding they failed to show that smoking cessation benefits to adults outweigh risks posed to youth.

The products included flavors, such as "Apple Crumble," "Dr Cola" and "Cinnamon Toast Cereal" by companies JD Nova Group, Great American Vapes, and Vapor Salon.

It comes as the Food and Drug Administration (FDA) is nearing a court-ordered September 9 deadline for submission of applications to remain on the market under new stricter rules that are reshaping the industry.

"Congress gave the FDA the authority to regulate tobacco products to protect the public from the harmful effects of tobacco use through science-based regulation," said Acting FDA Commissioner Janet Woodcock.

"We know that flavored tobacco products are very appealing to young people, therefore assessing the impact of potential or actual youth use is a critical factor in our decision-making about which products may be marketed." 

The products denied authorization may not be delivered to the market, or have to be removed if they have already reached shelves.

In all, the FDA has received applications from over 500 companies.

No decisions have so far been announced about the companies with the leading market share, Juul Labs and Reynolds American which makes Vuse e-cigarettes. 

E-cigarettes entered the US market in 2007 and have been the most commonly used tobacco product among American youths since 2014.

To curb youth vaping, the FDA last year barred flavors from smaller e-cigarettes that use pods, such as those made by market leader Juul.

Tank-based rechargeable vaping devices, primarily sold in vape shops, were left exempt.

US lawmakers also raised the federal minimum age for tobacco and e-cigarette sales from 18 to 21 in December 2019. 

About 3.6 million young people in the US were current (in the past 30 days) e-cigarette users in 2020, down from 5.4 million in 2019, according to the National Youth Tobacco Survey.

Agence France-Presse

France testing whether nicotine can prevent coronavirus disease

Nicotine could protect people from contracting the coronavirus, according to new research in France, where further trials are planned to test whether the substance could be used to prevent or treat the deadly illness. 

The findings come after researchers at a top Paris hospital examined 343 coronavirus patients along with 139 people infected with the illness with milder symptoms. 

They found that a low number of them smoked, compared to smoking rates of around 35 percent in France's general population.

"Among these patients, only five percent were smokers," said Zahir Amoura, the study's co-author and a professor of internal medicine. 

The research echoed similar findings published in the New England Journal of Medicine last month that suggested that 12.6 percent of 1,000 people infected in China were smokers. 

That was a much lower figure than the number of regular smokers in China's general population, about 26 precent, according to the World Health Organization (WHO). 

The theory is that nicotine could adhere to cell receptors, therefore blocking the virus from entering cells and spreading in the body, according to renown neurobiologist Jean-Pierre Changeux from France's Pasteur Institut who also co-authored the study.

The researchers are awaiting approval from health authorities in France to carry out further clinical trials. 

They plan to use nicotine patches on health workers at the Pitie-Salpetriere hospital in Paris -- where the initial research was conducted -- to see if it protects them against contracting the virus. 

They have also applied to use the patches on hospitalised patients to see whether it helps reduce symptoms and also on more serious intensive care patients, Amoura said. 

The researchers are looking into whether nicotine could help to prevent "cytokine storms", a rapid overreaction of the immune system that scientists think could play a key role in fatal COVID-19 cases. 

But with further research needed, experts are not encouraging people to pick up smoking or use nicotine patches as a protective measure against the virus. 

"We must not forget the harmful effects of nicotine," said Jerome Salomon, France's top health official. 

"Those who do not smoke should absolutely not use nicotine substitutes", which cause side effects and addiction, he warned.

Tobacco is the number one killer in France, with an estimated 75,000 deaths per year linked to smoking. 

France is one of the hardest hit countries by the coronavirus in Europe, with more than 21,000 deaths and over 155,000 reported infections. 

Agence France-Presse

Vaping kills a 15-year-old in Texas

Cases of lung illness and deaths from vaping have tapered off since peaking in September, health officials said on Thursday, but the outbreak also reached a grim new milestone: The youngest death, of a 15-year-old, was reported by Dallas County Health and Human Services.

The teenager had “a chronic underlying medical condition,” Texas officials said in a statement on Dec. 31, but they did not identify the condition, the patient’s gender or what products the patient had been vaping.

“Reporting a death in a teen due to Evali is so tragic,” Dr. Philip Huang, the Dallas County health director, said in a statement, referring to the official name for the disorder, E-cigarette or Vaping-Associated Lung Injury. “We are seeing that severe lung damage, and even death, can occur with just short-term use of these products.”

The statement said that one teenager in the Dallas area who was hospitalized with the illness reported having vaped for only one month.

Nationwide, there have been 2,602 cases of the illness and 57 deaths as of Tuesday, the Centers for Disease Control and Prevention reported on Thursday. The median age of those who died was 51, with a range of 15 to 75 years. Before the Texas teenager’s death, the youngest reported vaping fatality was a 17-year-old Bronx resident.

Many of the older patients who died were reported to have underlying health conditions. On Wednesday, Massachusetts reported its fourth death: a man in his 70s from Middlesex County who had vaped THC, state health officials said.

Although the outbreak seems to be slowing, states are still reporting new cases every week, and more deaths are being investigated, the CDC said.

Most patients had vaped THC, the high-inducing chemical in marijuana. The CDC said the cause of their lung damage was very likely to be vitamin E acetate, an oily substance added to stretch the supply of THC. Laboratories have found the vitamin in illegal THC products and in fluid samples from patients’ lungs.

How vitamin E acetate could injure the lungs is not known. Researchers have suggested that it might disrupt a natural substance in the lungs called surfactant, which helps keep air sacs open and is essential for breathing. Another possibility is that the vitamin oil, when heated in a vaping device, may break down into a powerful toxin that leaves the lungs with damage similar to the chemical burns seen in war victims attacked with poison gas.

Though much of the evidence points to THC, health officials say that does not mean nicotine vaping can be considered safe.

“While it appears that vitamin E acetate is associated with Evali, there are many different substances and product sources that are being investigated, and there may be more than one cause,” the CDC says on its website. “Therefore, the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.”

It adds: “There is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk.”

source: news.abs-cbn.com

US unveils partial ban on flavored e-cigarettes

WASHINGTON—The US government on Thursday announced it would soon ban most flavored e-cigarettes as it tries to curb a rising tide of youth vaping, but stopped short of the full ban promised in September by President Donald Trump.

The Food and Drug Administration said cartridge-based e-cigarettes in flavors "other than tobacco or menthol" would be illegal unless they receive specific authorization from the government.

Companies that do not cease making and selling such cartridges within 30 days will face punishment, the FDA said.

"The United States has never seen an epidemic of substance use arise as quickly as our current epidemic of youth use of e-cigarettes," Health Secretary Alex Azar said in a statement.

Azar said prioritizing flavors most widely used by children would ensure e-cigarettes were a potential "off-ramp" for adult smokers but not an "on-ramp" to nicotine addiction for youngsters. 

"We will not stand idly by as this crisis among America's youth grows and evolves, and we will continue monitoring the situation and take further actions as necessary," he added.

The 2019 National Youth Tobacco Survey shows that more than 5 million US middle and high school students are e-cigarette users, with nearly 1 million using daily. 

"Additional data from another federal survey further underscore that youth are particularly attracted to e-cigarette flavors such as fruit and mint, much more so than tobacco or menthol flavored e-cigarettes," the Department of Health and Human Services said.

The flavor ban will exempt large, tank-based vaping devices, however, which are primarily sold in vape shops that cater to adult smokers.

source: news.abs-cbn.com

Smokers who switch to e-cigarette vapes rapidly boost heart health: study

LONDON - Chronic smokers who switched from tobacco cigarettes to e-cigarette vapes in a large randomized control trial saw a significant improvement in markers of heart health after just a month, researchers said on Friday.

In study results likely to be closely scrutinized by health specialists worldwide, British scientists found that cigarette smokers who switched to nicotine-containing vapes saw a marked boost to their vascular function - a change that could lead to a significantly lower risk of cardiovascular disease.

“By switching from cigarettes to e-cigarettes we found an average percentage point improvement of 1.5 within just one month,” Jacob George, a professor of cardiovascular medicine and therapeutics at Britain’s Dundee University, told a briefing about the study.

“And to put that into context, each percentage point improvement in vascular function results in a 13% reduction in cardiovascular event rates, such as heart attack.”

Jacob stressed, however, that the study looked specifically at vaping compared with tobacco smoking, which causes lung and other cancers and sharply increases the risk of deadly strokes, heart attacks and many other cardiovascular diseases.

“It is crucial to emphasize that e-cigarettes are not safe, just less harmful than tobacco cigarettes when it comes to vascular health,” George said. “They should not be seen as harmless devices for non-smokers or young people to try.”

The findings, published in the Journal of the American College of Cardiology, will fuel further international debate about the potential risks and benefits of e-cigarettes amid more than 2,000 cases of vaping-related lung illness and more than 40 deaths in the United States in recent months.

U.S. Centers for Disease Control and Prevention experts say their investigations suggest the injuries are linked to vapes containing THC - the component of marijuana that gets people high - and Vitamin E acetate, which is believed to be used as a cutting agent in illicit THC vaping products.

British addiction and toxicology experts said last month that the American vaping illnesses were most likely “a U.S.-specific phenomenon,” and there was no evidence of a similar outbreak in Britain or elsewhere where the suspect products were not widely used.

For the Dundee-led switching trial, which took two years and was funded by the British Heart Foundation charity, researchers recruited 114 long-term cigarette smokers who had smoked at least 15 cigarettes a day for at least two years.

They were put into one of three groups for a month and had vascular testing before and after. One group stuck to tobacco cigarettes, the second switched to e-cigarettes with nicotine, and the third switched to e-cigarettes without nicotine.

The results showed that, whether or not the e-cigarettes contained nicotine, those who switched away from tobacco smoking found their endothelial function - a measure of how easily blood flows around the body - was significantly improved.

source: news.abs-cbn.com

Childhood smoking exposure tied to irregular heartbeat in adulthood

Children who grow up breathing their parents’ secondhand smoke are more likely to develop a heart rhythm disorder known as atrial fibrillation than the kids of nonsmokers, a recent study suggests.

Based on families in the decades-long Framingham study, researchers found that half of the children of smokers included in the analysis were exposed to at least a half pack, or 10 cigarettes, a day - and for every pack-a-day increase in smoke exposure, kids’ risk of developing atrial fibrillation in adulthood climbed by 18 percent.

A small part of the risk for adult atrial fibrillation was associated with the tendency of smokers’ children to become smokers themselves as adults, the study team notes in the Journal of the American College of Cardiology.

“Smoking may have unintended and unanticipated downstream harms that have not previously been considered as part of the actual total negative consequences of smoking,” said Dr. Gregory Marcus, senior author of the study and an atrial fibrillation researcher at the University of California, San Francisco.

“These findings demonstrate how parental behaviors and exposures can meaningfully influence their children in ways that may not become apparent until late in adulthood,” Marcus said by email.

For the study, researchers examined data on 2,816 children and at least one of their parents. Overall, 82 percent of the kids were exposed to secondhand smoke by a parent at some point during childhood.

A total of 404 kids or 14.3 percent developed atrial fibrillation after researchers followed half of the children for at least 4 decades.

Exposure to secondhand smoke from parents was also associated with a 34 percent higher risk that children would become smokers, researchers report in the Journal of the American College of Cardiology.

And, becoming a smoker explained about 17 percent of the increased atrial fibrillation risk tied to parental smoking.

In atrial fibrillation, electrical impulses in the upper chambers of the heart are chaotic, causing that part of the heart muscle to quiver rather than contracting normally. 

As a result, blood doesn’t move as well to the heart’s lower chambers. This can lead to the formation of clots that can travel through the arteries to the brain and cause a stroke.

The study wasn’t designed to prove whether or how secondhand smoke exposure during childhood might cause atrial fibrillation.

“Early exposure to tobacco smoke may result in damage to the pulmonary veins, the heart, or the interface between the two, which may increase the propensity to atrial fibrillation,” Marcus said.

One limitation of the study is that researchers lacked smoking data for a large proportion of parents, which may have resulted from limited awareness of the health risks of smoking when some of the families started being followed in the 1950s, researchers note. It’s also unclear how much exposure to smoke kids had in the womb, which might also impact atrial fibrillation risk.

Even so, the results should offer parents who smoke yet another reason to quit, Marcus said.

“Smoking unfortunately remains common, especially among young individuals of child-bearing age,” Marcus added. “Complete smoking avoidance or cessation is the most healthy strategy for parents that want their kids to experience long-term health.”

source: news.abs-cbn.com

US health officials expect 'hundreds more' cases of vaping-related illness

WASHINGTON, United States—Hundreds more Americans have been sickened by a severe vaping-related illness, with the official tally set to be updated on Thursday, according to a US health official speaking at a congressional hearing on Tuesday.

The House of Representatives began public hearings this week about the mystery lung disease that, as of last week, had sickened 530 people in 38 states. The illness has also claimed the lives of 9 people.

"We believe that probably hundreds more (cases) have come in since the numbers we released last week," said Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention (CDC).

The outbreak prompted Massachusetts on Tuesday to impose a 4-month ban on sales of all vaping products, including those used for tobacco and marijuana, which is legal in the state.

The move goes further than New York state and Michigan, which earlier this month banned the sale of flavored vaping products, out of concern that those products appeal to children.

E-cigarettes, which operate by heating a liquid to form an inhalable vapor, have been popular for nearly a decade in the United States.

At Tuesday's hearing Schuchat noted that latest-generation vaping devices use "nicotine salts" that boost the amount of the addictive substance that reaches the brain, presenting a particular risk to younger consumers, whose brains are still developing.

"It feels like that's kind of vaping on steroids," said Representative Raja Krishnamoorthi, chairman of the subcommittee on economic and consumer policy, as he called for further investigation.

Schuchat emphasized that the CDC has still not identified any specific product or compound - including tetrahydrocannabinol (THC), the high-inducing component of marijuana, or Vitamin E acetate - that is linked to all cases of the illness.

The CDC, which has activated its emergency operations center to coordinate an investigation, has advised that people quit vaping if they can.

A man over age 50 who used e-cigarettes died in Kansas as state health officials prepared to join the waves of experts testifying before Congress on Wednesday, Kansas Governor Laura Kelly announced.

“Today, I am saddened to announce the death of a second Kansan in association with this outbreak,” the governor said in a statement, noting the man had underlying medical conditions.

At Tuesday's subcommittee hearing, Dr. Ngozi Ezike of the Illinois Department of Public Health urged Congress to ban flavored vaping products, "which are particularly targeted to young people."

On Wednesday, the acting commissioner of the Food and Drug Administration will appear before a House Energy and Commerce subcommittee and be asked about the public health threats of e-cigarettes.

For those who continue vaping, public health officials urge consumers to avoid buying vaping products on the street, using marijuana-derived oil with the products or modifying a store-bought vape product.

The House Oversight Economic and Consumer Policy subcommittee's probe began in the summer, and so far has focused on the role e-cigarette maker Juul Labs Inc played in what the panel's chairman, Representative Raja Krishnamoorthi, an Illinois Democrat, has called a "youth vaping epidemic."

At Tuesday's hearing Representative Mark DeSaulnier, a Democrat from California, called Juul "shameless" in terms of the amount of information it has given to lawmakers.

In addition to Juul, in which Altria Group Inc has a minority stake, leading makers of nicotine e-cigarettes include British American Tobacco Plc and Imperial Brands Plc .

On Wednesday, health officials from Michigan, North Carolina, Kansas and Massachusetts will appear before the Energy and Commerce Health subcommittee along with Schuchat and the FDA's Norman Sharpless.

The FDA has warned Juul that it violated regulations because it marketed its vaping products as less risky than traditional cigarettes.

The popularity of e-cigarettes has now grown to the point where 1 in 4 12th-graders reported vaping a nicotine product during the previous 30 days. It is nearly 1 in 10 for 8th-graders, a study by the University of Michigan in Ann Arbor reported last week.

source: news.abs-cbn.com

Vaping-related lung illnesses: What you need to know

Hundreds of people across the US have been sickened by a severe lung illness linked to vaping, and a handful have died, according to public health officials. Many were otherwise healthy young people, in their teens or early 20s. Investigators from numerous states are working with the federal Centers for Disease Control and Prevention and the Food and Drug Administration in an urgent effort to figure out why.

Here’s what we know.

WHO IS AT RISK?

Anyone who uses e-cigarettes or other vaping devices, whether to consume nicotine or substances extracted from marijuana or hemp, may be at risk because investigators have not determined whether a specific device or type of vaping liquid is responsible.

The Food and Drug Administration is warning that there appears to be a particular danger for people who vape THC, the psychoactive chemical in marijuana. The FDA said a significant subset of samples of vaping fluid used by sick patients included THC and also contained a chemical called vitamin E acetate.

The FDA issued this statement: “Because consumers cannot be sure whether any THC vaping products may contain vitamin E acetate, consumers are urged to avoid buying vaping products on the street, and to refrain from using THC oil or modifying/adding any substances to products purchased in stores.”

But some of the patients who have fallen severely ill said they did not vape THC. In 53 cases of the illness in Illinois and Wisconsin, 17 percent of the patients said they had vaped only nicotine products, according to an article published Friday in The New England Journal of Medicine.

The researchers who wrote the journal article cautioned, “e-cigarette aerosol is not harmless; it can expose users to substances known to have adverse health effects, including ultrafine particles, heavy metals, volatile organic compounds and other harmful ingredients.”

The health effects of some of those chemicals are not fully understood, the researchers wrote, even though the products are already on the market.

WHAT ARE THE SYMPTOMS?

The early symptoms include fatigue, nausea, vomiting, coughing and fever, escalating to shortness of breath, which can become so extreme it can prompt an emergency room visit or require hospitalization.

Some patients have needed supplementary oxygen, including a ventilator in as many as a third of cases analyzed in The New England Journal of Medicine.

On lung scans, the illness looks like a bacterial or viral pneumonia that has attacked the lungs, but no infection has been found in testing.

WHAT'S THE BEST WAY TO PREVENT THE ILLNESS?

Health officials say that the riskiest behavior is using vaping products bought on the street instead of from a retailer, or those that have been tampered with or mixed.

Mitch Zeller, director for the Center for Tobacco Products at the FDA, said, “If you’re thinking of purchasing one of these products off the street, out of the back of a car, out of a trunk, in an alley, or if you’re going to then go home and make modifications to the product yourself using something that you purchased from some third party or got from a friend, think twice.”

The CDC and some state health officials have recommended that people give up vaping of any type until the cause of the lung damage is determined.

An editorial in The New England Journal of Medicine stated bluntly that doctors should discourage their patients from vaping.

E-cigarettes and other vaping devices were developed to help cigarette smokers quit their dangerous habit by providing a way to satisfy their nicotine addiction without inhaling the toxins that come from burning tobacco. But many medical experts now think even smokers should think twice about turning to e-cigarettes — and anyone who does not smoke should not vape.

“Adult smokers who are attempting to quit should consult with their health care provider and use proven treatments,” the authors of the analysis in The New England Journal of Medicine wrote.

They added, “Irrespective of these findings, e-cigarettes should never be used by youths, young adults, pregnant women and adults who do not currently use tobacco products.”

What should I do if I think I have the lung illness?

The CDC says: “If you are concerned about your health or the health of a loved one who is using an e-cigarette product, contact your health care provider, or your local poison control center at 1-800-222-1222.”

Anyone who has shortness of breath that lasts more than a few hours or becomes severe should seek medical attention quickly. It is a warning that should not be ignored, doctors say.

Why do health investigators think this is linked to vaping?

Health investigators believe the illnesses are linked to vaping for several key reasons: The patients have vaped nicotine or marijuana extracts, or both, and do not have an infection or other condition that would explain the lung disease. Patients are now characterized as having the illness only if they have reported vaping within 90 days. In many of the reported cases, the patients had vaped much more recently.

E-CIGARETTES HAVE BEEN AROUND FOR YEARS. WHY IS THIS HAPPENING NOW?

There are several theories. One is that some dangerous chemical or combination of chemicals has been introduced into the pipeline of vaping products. Public health officials believe that when people vape this noxious cocktail, it sets off a dangerous, even lethal, reaction inside the lungs. These officials have said repeatedly that they do not yet know which substance or device may be causing this reaction, and that is the subject of their urgent investigation.

A second theory is that this syndrome is not, in fact, entirely new and that some people had gotten sick previously, but that the condition had not been recognized and identified as being linked to vaping. As vaping has grown in popularity — both with nicotine and marijuana — more cases may be showing up.

For the time being, though, public health officials seem to believe that the first theory is more likely and they are hunting for a substance, substances or process that might explain the surge in illnesses.


2019 The New York Times Company

source: news.abs-cbn.com

San Francisco bans sales, manufacture of e-cigarettes

LOS ANGELES - San Francisco on Tuesday became the first major US city to effectively ban the sale and manufacture of electronic cigarettes, as concerns grow over a sharp rise in vaping among youths.

The city's legislature unanimously approved an ordinance suspending the sale in shops or online of e-cigarette products that lack approval by federal health authorities. No such approvals currently exist.

Backers said the ban was necessary due to the "significant public health consequences" of a "dramatic surge" in e-cigarette use among teenagers.

But the move triggered a swift backlash from critics who say it could drive former smokers back to conventional cigarettes.

US health authorities are alarmed by the rise in popularity of e-cigarettes, battery-powered devices that enable users to inhale addictive nicotine liquids that are often fruit flavored.

The potential health consequences of vaping, including fears it could stunt adolescent development, remain largely unknown, in part because the practice is so new.

The number of young Americans using e-cigarettes grew by 1.5 million in 2018, with about 3.6 million middle and high school students using vaping products.

San Francisco is home to market-leading e-cigarette maker Juul.

City Attorney Dennis Herrera, who co-sponsored the ban, said it closed a loophole that the federal U.S. Food and Drug Administration should have tackled long ago.

"E-cigarettes are a product that, by law, are not allowed on the market without FDA review," he said in a statement after the second and final vote to implement the ban.

"For some reason, the FDA has so far refused to follow the law. If the federal government is not going to act, San Francisco will."

'DEADLY CIGARETTES'

The city's mayor London Breed has 10 days to sign the legislation -- which she has said she will do -- with the ban due to take effect seven months later.

"We need to take action to protect the health of San Francisco's youth and prevent the next generation of San Franciscans from becoming addicted to these products," Breed said in a statement Tuesday ahead of the vote.

She added that e-cigarette companies were "targeting our kids in their advertising and getting them hooked on addictive nicotine products."

But critics say the legislation will make it harder for people seeking alternatives to regular cigarettes.

E-cigarettes do not contain the cancer-causing products found in tobacco.

An editorial in the Los Angeles Times noted that regular cigarettes were still for sale in San Francisco, arguing that "it's bad public health policy to come down harder on the lesser of two tobacco evils."

Juul said in a statement following the vote that the ban would "drive former adult smokers who successfully switched to vapor products back to deadly cigarettes, deny the opportunity to switch for current adult smokers, and create a thriving black market."

The manufacturer called instead for stricter regulation and enforcement including proof-of-age identification.

'INCREASE RISK'

Traditional "Big Tobacco" companies have increasingly marketed "smoke-free" products like e-cigarettes as far less harmful alternatives to the deadly habit they have long been peddling.

But experts point out that it took decades to determine that smoking tobacco -- which accounts for more than seven million premature deaths worldwide every year -- is truly dangerous.

The San Francisco ordinance text said that nicotine exposure during adolescence "can harm the developing brain" and "can also increase risk for future addiction to other drugs."

It would introduce fines of up $1,000 for each violation by vendors.

Unlike an e-cigarette ban in force in Singapore, the San Francisco legislation does not restrict the use of vaping products -- only sales, manufacturing and distribution.

Recreational cannabis use has been legal for adults in California since January last year.

amz-ban/ft

source: news.abs-cbn.com

E-cigarette use linked to heart trouble: study

People who use e-cigarettes are more likely to have heart problems than those who don't, says a study released on Thursday in the US.

The rate of heart attacks among those who vape was 34 percent higher than among those who don't, once corrections were made for risk factors such as age, gender, body mass index, cholesterol level, blood pressure and tobacco use.

E-cigarette users were 25 percent more likely to have coronary artery disease and 55 percent more likely to suffer from depression or anxiety, the study says.

"Until now, little has been known about cardiovascular events relative to e-cigarette use," said Mohinder Vindhyal, assistant professor at the University of Kansas School of Medicine and the study's lead author.

"These data are a real wake-up call and should prompt more action and awareness about the dangers of e-cigarettes."

The report does not however identify a cause and effect relationship for this observation.

Studies of people who vape are relatively new because the devices only came onto the US market in the last decade or so.

US health authorities are alarmed by the rise in popularity of e-cigarettes, battery-powered devices which enable users to inhale nicotine liquids that are often fruit flavored.

Among US teens, use of vaping devices rose 78 percent in 2018 compared to the previous year.

E-cigarettes do not contain the cancer-causing products found in tobacco.

But beside the well-known addictive consequences of consuming nicotine, public health experts are focusing on the effect of heating the liquid nicotine cartridges to high temperatures.

For the study, which will be presented next week at the American College of Cardiology, researchers examined the responses of nearly 100,000 people in 2014, 2016 and 2017.

This kind of study is a preliminary one that does not go so far as to say vaping causes heart trouble, or suggest a biological mechanism as to how this might happen.

Longer-term studies of people who vape are needed to reach any such conclusion.

source: news.abs-cbn.com

US orders restriction on e-cigarette sales; youth use surges

TAMPA - US regulators Thursday ordered sharp restrictions on sales of e-cigarettes, as national data showed a 78 percent single-year surge in vaping among young people, with two-thirds using fruit and candy-flavored products.

The proposed regulations announced by the Food and Drug Administration (FDA) would allow flavored e-cigarettes products to be sold in stores only, not online, and would also ban menthol in cigarettes and flavored cigars.

The changes are open to a public comment period lasting until June before they can take effect.

"These data shock my conscience," said FDA Commissioner Scott Gottlieb, referring to the latest data from the National Youth Tobacco Survey.

"From 2017 to 2018, there was a 78 percent increase in current e-cigarette use among high school students and a 48 percent increase among middle school students," he said.

A total of 3.6 million US youths reported vaping at least once in the past month, the data showed.

"These increases must stop. And the bottom line is this: I will not allow a generation of children to become addicted to nicotine through e-cigarettes," said Gottlieb. 

The battery-powered devices heat a nicotine liquid that users inhale, and are gaining popularity in the United States and abroad, particularly among young people, which Gottlieb has previously described as an "epidemic."

The proposed rules aim to restrict sales of all flavored vaping cartridges -- other than tobacco, mint and menthol -- to sales at "age-restricted, in-person locations and, if sold online, under heightened practices for age verification," said an FDA statement.

The reason mint- and menthol-flavored e-cigarettes are not included is they are more popular with adults who may be using them to decrease or stop their use of traditional cigarettes.

"This reflects a careful balancing of public health considerations," Gottlieb said, citing data that shows mint- and menthol-flavored e-cigarette products "are more popular with adults than with kids."

At the same time, the FDA announced a proposal to ban menthol in combustible cigarettes and cigars.

"I'm deeply concerned about the availability of menthol-flavored cigarettes," Gottlieb said.

"I believe these menthol-flavored products represent one of the most common and pernicious routes by which kids initiate on combustible cigarettes," he said, adding that "menthol products disproportionately and adversely affect underserved communities."

STOCKS SLIDE

Health experts applauded the FDA move.

"The banning of flavors, popular among teens, would definitely be an important step in curbing the growing epidemic of e-cigarettes among youth," said Patricia Folan, director of the Center for Tobacco Control at Northwell Health, a network of hospitals in New York.

Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said "it is widely recognized that e-cigarettes are the gateway to smoking tobacco cigarettes for teens and young adults."

E-cigarettes expose users to significantly lower levels of potentially toxic substances than traditional cigarettes, except for nicotine, the US National Academies of Sciences, Engineering and Medicine said earlier this year.

But Horovitz cautioned "there is a question of safety in e-cigarettes because of the presence of propylene glycol, and other as yet unidentified compounds."

Some e-cigarette makers have already taken steps to curb sales to young people, including JUUL, a fast-growing startup which announced Tuesday it is suspending in-store sales of various flavored products and scrapping its social media presence.

JUUL flavors such as mango, fruit, and creme will now only be available on the company's website, "where we are adding additional age-verification measures," a statement said. 

For its part, American tobacco giant Altria, maker of major brands like Marlboro and Chesterfield, said earlier this month it would stop selling 2 types of e-cigarettes that use "pods" of flavored nicotine liquid for refills.

Altria will maintain the sale of its other e-cigarettes -- which resemble conventional cigarettes and which come in traditional flavors like tobacco and menthol.

On Wall Street, tobacco stocks slid on the news, continuing a decline that began last week as media reports warned of the impending regulations.

Altria fell 1.86 percent at 1:45 (1845 GMT) while British American Tobacco (Dunhill, Lucky Strike, Pall Mall) lost 3 percent and Philip Morris International fell 0.26 percent.

source: news.abs-cbn.com

Air China incident linked to co-pilot smoking e-cigarette - state media

SHANGHAI - An emergency descent by an Air China aircraft after oxygen levels dropped in the cabin has been linked to a co-pilot who was smoking an e-cigarette during the flight, state media said on Friday, citing China's aviation regulator.

"In the preliminary investigation, the co-pilot was found to be smoking an e-cigarette," state-owned China News said in a report, citing a news conference by the Civil Aviation Administration of China investigating Tuesday's incident.

"Smoke diffused into the passenger cabin and relevant air conditioning components were wrongly shut off, without notifying the captain, which resulted in insufficient oxygen," it added.

The Air China Boeing 737 aircraft was flying to the Chinese city of Dalian from Hong Kong, when it made an emergency descent to 10,000 feet (3,048 m), during which oxygen masks were deployed, before climbing again to continue on to its destination. 

source: news.abs-cbn.com

Study of cancer-causing toxins finds e-cigarettes much safer than smoking

Consuming e-cigarettes is far safer and less toxic than smoking conventional tobacco cigarettes, according to the findings of a study analyzing levels of dangerous and cancer-causing substances in the body.

Researchers found that people who switched from smoking regular cigarettes to e-cigarettes or nicotine replacement therapy (NRT) such as gum or patches for at least six months had much lower levels of toxins in their saliva and urine than those who continued to smoke.

"Our study adds to existing evidence showing that e-cigarettes and NRT are far safer than smoking, and suggests that there is a very low risk associated with their long-term use," said Lion Shahab, a specialist in epidemiology and public health at University College London who led the work.

E-cigarettes, which heat nicotine-laced liquid into vapor, have grown into an $8 billion-a-year market, according to Euromonitor International - more than three times that of NRT products. They are, however, still dwarfed by a tobacco market estimated by Euromonitor to be worth around $700 billion.

Many health experts think e-cigarettes, or vapes, which do not contain tobacco, are a lower-risk alternative to smoking and potentially a major public health tool.

But some question their long-term safety and worry that they may act as a "gateway" to taking up conventional cigarettes. The U.S. surgeon general in December urged lawmakers to impose price and tax policies that would discourage their use.

Monday's study, published in the journal Annals of Internal Medicine, analyzed saliva and urine samples from long-term e-cigarette and NRT users as well as smokers, and compared levels of key chemicals found in their bodies.

It found that smokers who switched completely to e-cigarettes or NRT had significantly lower levels of toxic chemicals and carcinogens compared to people who continued to smoke tobacco cigarettes.

Those who used e-cigarettes or NRT but did not completely quit smoking did not show the same drop in toxin levels. This underlined that a complete switch was needed to get the long-term health benefits of quitting tobacco, the researchers said.

The World Health Organization says tobacco is the world's biggest preventable killer, with a predicted cumulative death toll of a billion by the end of this century if current trends continue. Tobacco smoking currently kills around 6 million people a year.

Kevin Fenton, national director of health and well-being at the government authority Public Health England, said the findings held a clear message for tobacco smokers.

"Switching to e-cigarettes can significantly reduce harm to smokers, with greatly reduced exposure to carcinogens and toxins," he said in a statement. "The findings also make clear that the benefit is only realized if people stop smoking completely and make a total switch.

"The best thing a smoker can do, for themselves and those around them, is to quit now, completely and forever."

(Reporting by Kate Kelland; Editing by Kevin Liffey)

source: news.abs-cbn.com

Smoking worsens diabetes complications

People with type 2 diabetes who smoke have significantly higher risks of heart disease, stroke, and death than diabetic non-smokers, a new study shows.

They also had higher risks of clogged arteries, heart failure, and reduced blood flow to the limbs.

The risks were lower for diabetics who quit smoking, but still moderately higher than risks among never smokers, the researchers write in the journal Circulation.

Lead author An Pan told Reuters Health by email that smoking is still common among people with diabetes, despite efforts to discourage it.

“We wanted to know whether smoking was related to total mortality and cardiovascular events among diabetic patients, and whether smoking cessation would reduce the risks,” said Pan, who is a professor at Huazhong University of Science and Technology in China.

According to the Centers for Disease Control and Prevention, smoking can worsen the health risks that go along with diabetes, such as heart and kidney disease, nerve damage, and blindness.

Pan’s team pooled the data from 89 earlier studies of smoking among adults with type 2 diabetes and found that diabetic smokers were around 1.5 times more likely to experience clogged arteries, stroke, overall heart disease, and heart failure.

In addition, smokers were more than twice as likely to suffer from peripheral artery disease, or reduced blood flow to the limbs, than patents who did not smoke.

Former smokers had 1.2 times the risk of clogged arteries and 1.1 times the risk of overall heart disease, compared to never-smokers.

Using the risk estimates from their review and global rates of deaths from diabetes, the researchers estimated that smoking accounted for 14.6 percent of deaths in diabetic men and 3.3 percent of deaths in diabetic women worldwide.

Dr. Wael Al-Delaimy, division chief of global health at the University of California, San Diego, said part of the problem may be the care diabetes patients receive.

“The physician caring for the diabetes patient might be focusing on cardiovascular risk factors or diabetes complications and diet and weight control while neglecting smoking as another important risk factor,” Al-Delaimy told Reuters by email.

Pan said some smokers may be reluctant to quit due to concerns about gaining weight in the short term. However, he noted, “The long-term benefits clearly overweigh the short-term side effects.”

Pan advises diabetic patients who are smokers “to seek professional help to quit smoking.”

Al-Delaimy agreed, saying, “If you are a patient suffering from diabetes and smoking cigarettes, or if you know a family member, friend or anyone else who is diabetic and smoking, there is still opportunity to substantially decrease further complications and suffering or even early death by quitting smoking.”

source: www.abs-cbnnews.com

Singapore clamps down on shisha smoking

SINGAPORE - The Singapore government said Tuesday it would phase out public shisha smoking to protect young people who feel that smoking tobacco through water pipes is less harmful than cigarettes.

Faishal Ibrahim, parliamentary secretary for the health ministry, told a legislative session that a ban on new licences for shisha imports and sales would come into force this month.

Existing importers and retailers will be given until July 2016 to shift to other businesses.

"In view of the health risks associated with shisha smoking and to prevent the proliferation and entrenchment of shisha smoking in Singapore, my ministry intends to prohibit the import, distribution and sale of shisha," Faishal told lawmakers.

Faishal said government surveys showed the proportion of students using alternative tobacco products had increased from two percent in 2009 to nine percent in 2012.

source: www.abs-cbnnews.com

Passive smoking causes irreversible damage to kids' arteries

LONDON - Exposure to second-hand smoke in childhood causes irreversible damage to children's arteries - increasing their risk of heart attacks or strokes when they grow up, according to a large international study published on Wednesday.

The research, which lends weight to campaigns for smoking to be banned in private cars and homes, found passive smoking leads to a thickening of children's artery walls, adding some 3.3 years to the age of blood vessels by adulthood.

"Exposure to passive smoke in childhood causes direct and irreversible damage to the structure of the arteries," said Seana Gall, a researcher in cardiovascular epidemiology who led the study at the University of Tasmania.

She said parents, or even those thinking about becoming parents, should quit smoking - both to aid their own health and protect the future health of their children.

Smoking causes lung cancer, which is often fatal, and is the world's biggest cause of premature death from chronic conditions like heart disease, stroke and high blood pressure.

On top of the 6 million people a year killed by their own smoking, the World Health Organization (WHO) says another 600,000 die a year as a result of exposure to other peoples' smoke - so-called second-hand or passive smoking.

Of the more than 4,000 chemicals in tobacco smoke, at least 250 are known to be harmful and more than 50 are known to cause cancer, the WHO says - and creating 100% smoke-free environments is the only way to protect people fully.

About 40% of all children are regularly exposed to second-hand smoke at home, and almost a third of the deaths attributable to second-hand smoke are in children.

Artery walls

This latest study, published in the European Heart Journal, was the first to follow children through to adulthood to look at links between exposure to parents' smoking and thickness of the innermost two layers of the arterial wall, known as carotid intima-media thickness (IMT).

Researchers from Finland and Australia looked at data from 2,401 people in Finland 1,375 people in Australia who were asked about their parents' smoking habits. The scientists used ultrasound to measure the thickness of the children's artery walls once they had reached adulthood.

The results showed that carotid IMT in adulthood was 0.015 millimeters thicker in those exposed to both parents smoking than in those whose parents did not smoke.

Gall said that while this was a "modest" increase, it was nonetheless an important extra and irreversible risk for suffering heart attacks or strokes later in life.

Since children of parents who smoke are also more likely to grow up to be smokers themselves, and more likely to be overweight, their heart health risks are often already raised, she said, and the second-hand smoke adds yet more risk.

The researchers said the findings showed reducing children's exposure to smoke is a public health priority.

"Legislation can reduce passive smoke exposure, with restriction of smoking in public places reducing hospitalizations for cardiovascular and respiratory disease," they wrote, adding that banning smoking in cars with children in them would also have a significant positive effect.

The United States, Australia and Canada have already banned smoking in cars carrying children, and Britain said last month that it too would be introducing a ban soon.

source: www.abs-cbnnews.com

Phil Everly of the Everly Brothers dies at 74

LOS ANGELES - Singer Phil Everly of the famed Everly Brothers died Friday, his widow told The Los Angeles. He was 74.

Everly passed away in the Californian city of Burbank due to complications from chronic obstructive pulmonary disease, Patti Everly told the newspaper.

"We are absolutely heartbroken," she said, noting her husband's disease was caused by a cigarette smoking. "He fought long and hard."

Together with his brother Don, who survives him, Everly rose to fame in the late 1950s and 1960s for smash hits such as "Wake Up Little Susie," "All I Have to Do is Dream" and "Bye Bye Love."

The duo, who influenced The Beatles as well as Simon and Garfunkel, were known for their close-harmony singing.

The Rock and Roll Hall of Fame, into which the Everly Brothers were inducted in 1986, described their harmonies as "one of the musical treasures of the 1950s and a major influence on the music of the 1960s."

In 1957, the Everly Brothers signed their first record deal and soon after produced hits that spawned the genres of pop, rock and country. They were inducted into the Country Music Hall of Fame in 2001.

Tributes poured in soon after word of Everly's death surfaced.

"Rest in peace Phil Everly. You guys brought us a lot of pleasure back in the day," rock and country singer-songwriter Charlie Daniels tweeted.

Commenting as a winter snowstorm hit the northeast United States, actor and musician John Gallagher Jr. said: "This cold night just got colder. RIP Phil Everly. The Everly Brothers Greatest Hits was my first CD as a kid and will always be a favorite."

"They had that sibling sound," said Linda Ronstadt, who recorded one of the biggest hits of her career in 1975 with her interpretation of Everly's "When Will I Be Loved."

"The information of your DNA is carried in your voice, and you can get a sound (with family) that you never get with someone who's not blood-related to you," she told the Times.

"And they were both such good singers -- they were one of the foundations, one of the cornerstones of the new rock 'n' roll sound."

According to a Rolling Stone biography of the legendary performers -- hailed as "the most important vocal duo in rock" by the magazine -- Phil and his younger brother Don were the children of Midwestern country stars Ike and Margaret Everly and performed on the family radio show while growing up.

As teenagers, they headed for Nashville, Tennessee, and began their stellar career.

In addition to his wife and brother, Everly is survived by their mother, Margaret, sons Jason and Chris, and two granddaughters.

The Times said funeral services would be private.

source: www.abs-cbnnews.com

Graphic warnings on cigarette packs on Senate agenda

MANILA - Sen. Pia Cayetano is determined to push for a measure mandating graphic health warnings on cigarette packs in the 16th Congress, while anticipating strong opposition from tobacco companies.

Cayetano stressed that the measure, which requires the use of pictures showing the dangers of smoking, needs to be passed to discourage people from even trying it.

The senator defended the bill in the 14th Congres, but it was not passed largely because of objections from tobacco companies.

"It's high time," Cayetano told reporters on Tuesday. "I make this humanitarian appeal to the corporate citizens out there [who] are involved in the tobacco industry. Panindigan naman po natin ang responsibilidad natin sa society."

"I find it is the height of irresponsibility when corporate citizens, companies will object to very responsible measures like this," she added.

Among the points that had been raised against the bill before was the additional cost of producing graphic health warnings.

Cayetano, however, noted: "The price you pay for not informing the public of the health risk is so much more than the additional cost of printing a full-color health warning."

At a meeting on Tuesday, Sen. Franklin Drilon told visiting lawmakers from South Korea that the bill on graphic warnings will be a priority health measure in the next Congress.

He himself had vowed to push for it.

Drilon, touted as the next Senate president, cited the passage of the reproductive health and sin tax laws in the previous Congress as among their biggest achievements for the health sector.

source: www.abs-cbnnews.com

Smoking to blame for Dolphy's COPD

MANILA, Philippines - Smoking is the main cause of the chronic obstructive pulmonary disease that Comedy King Dolphy battled for six to eight years before finally succumbing Tuesday at 83.

Eric Quizon, Dolphy’s son, admitted in an interview that his father used to smoke.

In an emotional necrological service, singer Zsa Zsa Padilla, Dolphy’s long-time partner, said they initially could not understand why the comedian constantly felt sick even if he showed no outward symptoms like fever.

Eventually, from yearly medical checkups, he had to be make regular hospital visits, “hanggang (until) two-and-a half years ago, sinabi na sa amin ng doctor na Stage 4 na siya ng COPD. Kinailangang kausapin ang lahat ng mga anak niya (the doctor said he already had Stage 4 COPD. It became necessary to talk to all his children),” Padilla said.

Persons suffering COPD experience breathlessness, abnormal sputum characterized by a mix of saliva and mucus, and chronic cough. And as the condition worsens, normal activities like walking up short flights of stairs or carrying a suitcase can be very difficult.

Aside from smoking, pollution - both indoor and outdoor - can also cause COPD, the World Health Organization said in its website.

It is not known how many Filipinos suffer from COPD but the Department of Health lists it as the seventh in the top 10 causes of mortality in the country.

And in 2000, a workshop covering the Asia-Pacific region estimated that at least 6.3 percent of the Philippine population is suffering from COPD.

Not surprising in a country where there are at least 17 million smokers.

But the DOH website stressed that these are “misleading figures because COPD is under-diagnosed and often not listed either as primary or contributory cause of death.”

Second-hand smokers, including children, are also at risk for COPD.

An estimated 10 people die every hour in the Philippines because of tobacco use, causing a humongous health burden of about P300 billion a year.

Other factors that cause COPD include indoor and outdoor pollution, according to the World Health Organization website.

The WHO estimates that 64 million suffered from COPD in 2004, with more than three million dying of the disease in 2005, equivalent to five percent of all deaths in the world that year.

Ninety-percent of COPD deaths occur in low- and middle-income countries like the Philippines where the use of tobacco is high.

Without interventions to cut the risks and better tobacco-control management, deaths from COPD are projected to increase by more than 30 percent over the next 10 years, the WHO warned.

Because symptoms develop slowly, COPD goes mostly undiagnosed although the WHO said people normally diagnosed with the disease are aged 40 or older.

The disease is diagnosed through a test called spirometry that measures how much air a person can inhale and exhale and how fast oxygen passes through the lungs.

There is no cure for COPD, but risk of it can be avoided or lowered by refraining from, or quitting, smoking.

source: interaksyon.com