Harm Reduction

Just last week we reported that the smoking rate in New York City dropped to an all-time low of 14 percent down from 22 percent in 2002. The rate of smoking in the state as a whole has also declined. So we were surprised to read that the American Cancer Society (ACS) is criticizing the state for spending less than the recommended amount on tobacco control programs.
Upon initially reading the results of new research that found that nearly 30 percent of U.S. male smokers between the ages of 18 and 24 who were living in snus test market areas had tried the product, Dr. Ross thought the study was going to finally reveal the truth about snus and other smokeless tobacco products that they can help smokers get off deadly cigarettes. Unfortunately, however, Dr. Ross was gravely disappointed since the study led by the Center for Survey Research at the University of Massachusetts and Legacy, a national public health foundation arrived at an opposite conclusion.
Finally a bit of sound science and common sense seems to be percolating from an official governmental agency unfortunately, not in our country. The U.K.'s Cabinet level behavioral insight team, better known as the nudge unit, is encouraging the use of smokeless nicotine cigarettes to help addicted smokers quit, thus hoping to prevent tens of thousands of smoking-related deaths among Britons. Published on Thursday, the unit's first annual report states: If alternative and safe nicotine products can be developed which are attractive enough to substitute people away from traditional cigarettes, they could have the potential to save 10,000s of lives a year.
More good news on the anti-smoking front strikes closer to home, as the latest statistics reveal that adult smoking rates in New York fell to a record low of just 14 percent in 2010, compared to 22 percent in 2002. The declining trend was also present among high school students, since only 7 percent were smokers last year as opposed to 18 percent in 2001. New York City Mayor Michael Bloomberg was particularly delighted by the news, since much of his time in office has been spent battling smoking, which includes passing a monumental law in 2002 that banned indoor smoking from bars, restaurants, and offices throughout the city.
As the nation works to curb smoking, the Centers for Disease Control and Prevention (CDC) presented some statistics on lung cancer rates that serve as inspiration for all who work in the trenches of public health: National lung cancer rates have declined, particularly among women, who witnessed a 2 percent decrease between 2006 and 2008. That decline in lung cancer incidence was even greater in the West, which experienced a 4 percent decline. In fact, the decrease in the rate of new lung cancer cases was largest among Western states, including California and Texas, which saw the greatest improvements.
Unfortunately, not all the news is good news: A recently proposed measure in the Russian Federation, much to our (and all others devoted to reducing the toll of smoking) chagrin, aims to ban the manufacture, sale, and importation of smokeless tobacco products. ACSH's Dr. Gilbert Ross is urging the Russian government, in website comments and letters to several ministers, to reconsider enacting such a ban. The Russian health authorities are probably not well-versed in the data on harm reduction, and don't know that these products could help the over 40 million Russian smokers quit and reduce their health risk by over 90 percent.
In his TobaccoAnalysis blog, ACSH advisor Dr. Mike Siegel, professor at Boston University s School of Public Health, reports on the FDA s Center for Tobacco Products latest initiative to compile a list of the ingredients found in cigarettes and cigarette smoke. This endeavor, he says, is a pointless waste of time and resources, since there is nothing the agency can actually do with the list that would benefit public health. Dr. Siegel points out that of the 10,000 to 100,000 chemicals present in cigarette smoke, only about 4,000 to 6,000 have actually been identified. Furthermore, it is unknown which constituents, at what levels, and in what combinations are responsible for the wide spectrum of diseases caused by smoking.
About 40 percent of cigarettes in New Jersey are smuggled into the state, according to a recent state Treasury Department report. And the figure hardly seems surprising, given that New Jersey levels a $2.70 tax on each pack of cigarettes sold. The high tax has created not only a significant black market for cigarettes in the state, but has also resulted in smokers purchasing their cigarettes out of state either via the Internet or by driving across state lines.
The number of adults smoking 10 or more cigarettes a day has declined slightly, but more adults now smoke one to nine cigarettes daily, according to the latest report from the Centers for Disease Control and Prevention (CDC).
While the FDA is in the process of assessing how it will regulate modified risk tobacco products, a new study in Harm Reduction Journal reports that smokers remain largely misinformed about the relative safety of these products compared to cigarettes. The study draws from data collected between 2002 and 2009 from over 21,000 smokers in Canada, the U.S, the U.K., and Australia, where public education and access to smokeless products is varied.
An FDA-authored analysis of electronic cigarette contents has just appeared in the Journal of Liquid Chromatography and Related Technologies. The agency has, in the past, gone out of its way to find hypothetical dangers of e-cigarettes even going so far as to try to bar their importation (a Federal judge stopped that attempt). This most recent article s slant is in keeping with the FDA s enduring prejudice against this clean nicotine delivery device.
ACSH s Dr. Gilbert Ross and Jody Manley have just returned from an FDA workshop on modified risk tobacco products (MRTP), which was convened as directed in the 2009 law granting regulatory authority over tobacco products to the FDA. The goal is to assess the form that such regulation will take over MRTPs such as smokeless and dissolvable tobacco, as well as electronic cigarettes (e-cigarettes). Fourteen speakers with varying degrees of expertise on MRTPs briefly presented their opinions, prior to a variety of panel discussions designed to provide the FDA with the input they need to approve marketing tobacco products that make modified risk claims.