European Respiratory Journal
ERJ November 1, 2011 vol. 38 no. 5 1219-1220

http://erj.ersjournals.com/content/38/5/1219.extract

Saliva cotinine levels in users of electronic cigarettes

J-F. Etter and C. Bullen

To the Editors:

Electronic nicotine delivery systems (ENDS or electronic cigarettes) look like cigarettes but do not contain or burn tobacco. Instead, they comprise a battery-powered atomiser that produces a vapour for inhalation from cartridges containing humectants (propylene glycol or glycerol), flavours (e.g. tobacco, mint or fruit) and nicotine. Many smokers report using ENDS to quit smoking or to substitute for tobacco in smoke-free places [1, 2]…

Because ENDS are purchased mainly on the internet [1, 2], we posted a questionnaire in English and French on the smoking cessation website Stop-Tabac.ch between September 2010 and January 2011. We asked discussion forums and websites informing about ENDS or selling them to publish links to the survey (http://www.stop-tabac.ch/fr_hon/ECIG_EN). The online questionnaire covered ENDS use (current/past and duration), smoking status, age, sex and postal address. Current ENDS users were sent by mail a plastic vial, a consent form and an additional questionnaire on paper, which covered ENDS use (days per week), brand and model, whether their current ENDS contained nicotine, nicotine dosage, puffs•day−1, refills•day−1, tobacco cigarettes per day (in smokers), quit date (in ex-smokers) and any tobacco, nicotine replacement therapy (NRT) and ENDS use in the previous 48 h. Participants were aged >18 yrs and the study was approved by the ethics committee of the Geneva University Hospitals (Geneva, Switzerland)…

We found substantial amounts of cotinine in the saliva of ENDS users. These results contrast with two laboratory reports that concluded that ENDS did not reliably increase blood nicotine levels [3], or provided lower levels than nicotine inhalers or tobacco cigarettes [4]. The differences with our study may be explained by different durations of exposure, users’ experience with the devices, puffing characteristics, models used and the swallowing of nicotine. In our study, experienced users puffed intensively and had been using ENDS regularly for months, whereas the previous studies were conducted in ENDS-naïve users. Experience with the device is likely to have influenced blood nicotine/cotinine levels. The correlation between puff number and cotinine suggests that puffing topography is an important factor that should be controlled for in future studies…

Nevertheless, cotinine levels in ENDS users were similar to levels previously observed in smokers [6] and higher than levels previously found in NRT users [7, 8]. Cotinine levels are roughly similar when measured in blood or in saliva [6, 9, 10], so studies using cotinine in blood and in saliva can be compared. Participants had not smoked for ≥20 days and had not used NRT or smokeless tobacco for ≥48 h (about three times the half-life of cotinine in smokers) [10]. Thus, results are unlikely to be contaminated by other sources of nicotine. All participants but one were former smokers, suggesting that ENDS are used much like NRT, to assist quitting, with similar or even larger effects on nicotine exposure. In this light, it seems logical to apply the same evaluation requirements to ENDS as to NRT. Even though propylene glycol is authorised as an additive in foods and medications, the effects of repeatedly inhaling a vapour containing propylene glycol over long periods are unknown..
We conclude that cotinine levels in ENDS users were similar to levels observed, in previous reports, in smokers and higher than levels usually observed in NRT users. This finding has important implications for ENDS use by smokers who want to quit, for future research, and for the regulation of these products.

I believe many will find this article of significance!

Columbus, GA Nov. 3, 2011 — In a generous display of support for the premium cigar industry and lifestyle, Altadis U.S.A. Premium Cigar Division recently presented IPCPR with a significant financial contribution to the association’s legislative efforts.
The contribution was in addition to Altadis’ longtime relationship with IPCPR, including corporate membership, volunteer service on the IPCPR Associate Member Advisory Board, and sponsorship and participation in the association’s Annual Convention and International Trade Show.
According to Javier Estades, General Manager of Premium Cigars for Altadis U.S.A., “IPCPR has been particularly active on a variety of state and federal legislative issues — past and current. We wanted to show our support of those successful strategies and actions.”
Janelle Rosenfeld, Vice President of Premium Cigar Marketing, added that Altadis U.S.A. will “add a section to our consumer website with links to the IPCPR site encouraging consumers and retailers to take action regarding current legislative issues.” See http://altadisusa.com.
Curt Diebel, President of IPCPR, expressed the association’s appreciation of the Altadis U.S.A. contribution. “This further validates our work on behalf of the industry and demonstrates the importance of all premium cigar stakeholders’ involvement in the effort,” he said.
Bill Spann, IPCPR CEO, thanked Altadis for its generous contribution.
“Altadis U.S.A Premium Cigar Division truly understands that a ‘rising tide floats all boats. We will put this kind donation towards fighting the good fight. Together, we will work to protect the simple value we all cherish: businesses’ absolute right to sell a legal product at a fair profit to adults who freely choose to enjoy premium cigars. What could be more American than that?” Spann said.
# # #
Contact: Tony Tortorici
678-493-0313
tony@tortoricipr.com

Altria to Cut Cigarette Workforce
Citing volume declines, company plans $400-million cost reduction
By LINDA ABU-SHALBACK ZID
CSP Daily News | October 27, 2011
RICHMOND, Va. — In a move attributed to cigarette volume declines following the 158% increase in federal excise taxes in April 2009, Altria Group Inc. announced yesterday that it will be cutting its cigarette-related salaried workforce.

During a third-quarter earnings call Thursday morning, Mike Szymanczyk, chairman and CEO, said the company plans a $400-million cost-reduction program in its cigarette infrastructure.

He declined to provide further details on the effect on employees or at what level layoffs would be made. He did say, “A substantial portion of the charges were resolved in cash expenditures related primarily to employee separation costs of approximately $300 million.” He added, “The charges also reflect other associated costs, including lease termination and asset impairment.”

The cuts will amount to the company’s cigarette-related salaried workforce being cut by about 15%, according to the Wall Street Journal.

“Employees whose jobs are eliminated would be informed by mid-December and would mostly leave the company by late February. The reduction, which doesn’t include hourly employees, would affect employees across the U.S., mainly in the Richmond, Va., area,” according to the paper, which also said employees would receive benefits, including continuation of salary and benefits for a minimum of 25 weeks and up to 18 months, depending on length of service.

Meanwhile, despite total cigarette volume declines of 9%, Altria reported a 3.7% net revenue increase in its profits from a year earlier to $1.17 billion, due to expanding margins and smokeless revenue.

Other highlights from the call:

Marlboro volume fell 10%, while its market share lost 0.9 points to end up at 41.7% of the U.S. market. Szymanczyk said the share was negatively impacted by relative changes in manufacturers’ promotional activities. “Following PM USA’s July 2011 list-price increase, Marlboro’s retail price increased more than major competitive premium and discount brands as PM USA focused on growing its adjusted operating companies’ income margins.”
After adjusting for trade inventories, USSTC and PM USA’s combined smokeless segment volume was estimated to be up approximately 5% for the third quarter.
Black & Mild’s retail share declined half a share point to 29.2% for the third quarter, but was up four-tenths of a share point for the first nine months of this year and sequentially vs. the second quarter of 2011. The brand’s retail share performance has benefited from brand-building initiatives and new-product introductions. In the fourth quarter, Middleton plans to nationally introduce an untipped version of Black & Mild Wine, which will be available in a new Aroma Wrap foil pouch.
Altria directly or indirectly owns 100% of each of Philip Morris USA, U.S. Smokeless Tobacco Co., John Middleton Co., Ste. Michelle Wine Estates and Philip Morris Capital Corp.

Thoughts? Will we see this elsewhere? What is really causing the volume & share decline at Altria?

NACS Submits Comments to FDA on Warning Letters, Multiple Violations

WASHINGTON, D.C. — The National Association of Convenience Stores (NACS) submitted comments to the Food and Drug Administration’s (FDA) Center for Tobacco Products (CTP) on its interpretation of the use of warning letters and multiple violations for tobacco retailers.

The comments were prompted by the FDA’s indication that tobacco retailers could be penalized for multiple violations found during a single inspection, something NACS said it does not believe is allowable under current written law.

“It is unclear whether or not CTP’s policy is to charge retailers with more than one violation resulting from single inspections. It is also worth noting that treating a warning letter as encompassing multiple violations would directly contradict the CTP’s position…that retailers are not entitled to due process to challenge warning letters,” NACS said.

However, in its comments, NACS also noted its support for the CTP’s indications that it will issue regulations on retailer training programs and what retailers can do to make sure the FDA pre-approves their training programs, resulting in lower penalties for violations. NACS also urged the FDA to approve the We Card program.

The FDA’s regulations and enforcement options were a hot topic at the 2011 NACS Show in Chicago earlier this month. During the workshop, “Blowing Through the Smoke: What’s Up With Tobacco,” David Fialkov, an associate of Steptoe & Johnson LLP, educated attendees on what retailers could expect from the FDA and what aspects of penalties remain unclear.

“We’re troubled by the lack of due process,” Fialkov said during his presentation, noting that the FDA does not provide a process for contesting allegations in a warning letter.

WHAT ARE YOUR THOUGHTS? IS THIS NORMAL PROTOCOL? I WOULD THINK THAT CLARITY WOULD BE PARAMOUNT OF THE FDA!

An excellent article recently found on Brad Rodu’s b;og very insightful. http://rodutobaccotruth.blogspot.com/

Wednesday, October 5, 2011
British Government Endorses Tobacco Harm Reduction, E-Cigarettes
The British Cabinet Office’s Behavioural Insights Team (BIT), or the “nudge unit”, as the year-old high-level group is called, strongly endorsed tobacco harm reduction in its first annual report (read the report here).

The BIT’s mission is “to find intelligent ways to encourage, support and enable people to make better choices for themselves.” The unit reported that “smoking remains the biggest preventable cause of death in the U.K., killing over 80,000 a year in England alone,” and that “treating smoking-related diseases costs the [National Health Service] £2.7 billion each year in England.”

BIT observed: “A review by the [British] Medicines and Healthcare products Regulatory Agency concludes that ‘nicotine, while addictive, is actually a very safe drug.’ BIT is working with [the U.K. Department of Health] on how to encourage smokers to substitute to safer but nonetheless appealing sources of nicotine, noting that products that produce a fine vapour appear to reproduce the pleasant ‘hit’ without the harms associated with smoking.”

This statement is remarkable. It confirms what I have been reporting for over 17 years: Nicotine, “while addictive, is a very safe drug.” BIT observes that nicotine is a recreational drug that can be used safely, like caffeine and alcohol, and notes that there are efforts to get smokers to substitute “safer but nonetheless appealing sources of nicotine”. E-cigarettes are cited as potentially effective substitutes because of their behavioral attributes.

This positioning by such a high-level entity should significantly advance tobacco harm reduction initiatives on a global scale. U.S. regulatory authorities, in particular, should take note. For the British government, the challenge now is to translate concepts into practical applications. Although e-cigarettes are widely available in the UK, snus and other smoke-free products remain under an EU ban. As awareness of the benefits of tobacco harm reduction increases, British smokers will rightfully demand access to the full range of smoke-free products that are available in Sweden and the U.S.
Posted by Brad Rodu

What are your thoughts? Will this be helpful to the cause of Harm Reduction?

The following article was posted in the ashtray blog at http://www.ecigarettedirect.co.uk/ashtray-blog/2010/05/glaxosmithkline-risks-lives-with-lies-in-cynical-attempt-to-increase-profits.html

We may not sell smokeless tobacco, but there is no doubt that it is a fantastic product that has saved the lives of thousands of ex-Swedish smokers.

The country has the lowest rates of lung cancer in Europe – simply because many of its smokers have switched to safer forms of tobacco use.

How safe is it?

According to Joel Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians:

the literature on snus [one of the safest forms of smokeless tobacco], which is evaluated on our website, basically shows that in the best of the epidemiological studies available today snus do not increase any cause of death. In other words, if there is a health hazard from snus it is smaller than can be measured with these studies.

Nitzkin Interview

But Glaxosmithkline states:

“A lot of people believe that taking smokeless tobacco is safer than smoking cigarettes. This is not true.”

From Nicorette

Bullshit!

So why do GSK oppose smokeless tobacco?

Here’s one possibility:

The harm in smoking is caused by combustion, rather than by the ingredients in which we smoke – which is why there is no point in switching to herbal cigarettes.

When taking up products like Snus, the risk to people’s health decreases so much that the incentive to quitting is hugely decreased.

That threatens companies selling NRT products. NRT products have a long term success rate (measured at one year) of around 5%. That guarantees a nice recurring market for pharmaceutical companies like GSK, especially as they pay money to the anti-smoking groups which recommend NRT products over cold turkey (which some studies show is a more effective way of quitting).

So if people do not switch to smokeless tobacco, they will continue trying to quit and they will continue to do so by using pharmaceutical products.

And they will also continue to die of avoidable smoking diseases.

Thoughts and comments are encouraged!strong>