Tobacco Asia

Volume 20, Number 4

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tobaccoasia 33 E-CIGARETTE NEWS 电子烟新闻 benchmark for the maximum achievable exposure reductions. The second group used e-cigarettes exclusively and the third used both e-cigarettes and their usual brand of tobacco cigarettes. Encouragingly, in eight out of the nine urinary biomarkers we studied, the reductions in levels of HPHCs following exclusive use of e-cigarettes were almost indistinguishable from reductions in smokers who stopped altogether during the same time. The obvious exception was nicotine." In the blood of both e-cigarette users and smokers who quit, levels of carbon monoxide were reduced by over 75%. Levels of volatile organic compounds such as acrolein, benzene, and 1-3-buta- diene were reduced by over 80% in both groups. Similarly, levels of tobacco- specific nitrosamines were reduced by 66-98% in the cessation group, and 62-93% in the e-cigarette group. "Interestingly, when it came to the dual use group who halved their self-reported daily cigarette consumption of tobacco cigarettes by using e-ciga- rettes, we also saw reductions in exposure to HPHCs that were broadly proportional to the reduction in number of cigarettes smoked," said O'Connell. "The findings support earlier research conducted by Fontem Ventures which showed that e-cigarette vapor is over 95% less toxic than smoke from a cigarette, contains over 95% less HPHCs, and does not negatively impact indoor air quality, unlike conventional cigarette smoke." "These latest findings are encourag- ing in that they support the results of other third party studies, which conclude that e-cigarettes offer smokers a less harmful alternative to tobacco," said Marc Michelsen, senior vice president of corporate affairs and communications at Fontem. US UNC Advise Against E-Cigs The health benefits of quitting smoking are widely accepted, but researchers from the University of North Carolina at Chapel Hill (UNC) have taken issue with the suggestion that doctors should routinely recommend e-cigarettes as an alternative to cigarettes for their patients who smoke. The researchers point out in a commentary recently published in Annals of Family Medicine that existing treatments are more effective than e-cigarettes to help people quit smoking, there are professional ethics concerns about providers who recommend them, and there is no strong evidence that e-cigarettes are safe. The researchers described notable safety and health concerns about e-cigarettes. Batteries inside e-cigarettes have caught fire or exploded, and particulate matter from e-cigarettes, which has been shown to be present in similar numbers to cigarettes, can increase the risk of cardiovascular and respiratory diseases. UNC researchers' commentary served as a counterpoint to a paper in the same journal issue by Ann McNeill, PhD, professor of tobacco addiction at King's College London, that suggests e-cigarettes are a less harmful way for smokers, including those trying to quit, to use nicotine. "Though e-cigarettes are likely not as harmful as conventional cigarettes, a growing number of studies report that they are by no means harmless," said Clare Meernik, MPH, a research specialist in the UNC Department of Family Medicine. The researchers also noted that e-cigarettes have been less effective than existing treatments to help people quit smoking. But while the researchers advise against the routine recommendation of e-cigarettes, they know firsthand that smoking cessation for individual patients is rarely black and white, and that providers must look at each patient's unique situation. Malaysia Stricter Laws Ahead E-cigarettes should be strictly regulated as a pharmaceutical product in Malaysia – that's the recommendation of the health ministry's technical committee tasked with studying the health effects of e-cigs and shisha smoking, reveals its chairman, senior consultant chest physician Prof Datuk Dr Abdul Razak Muttalif, a former director of the Kuala Lumpur Hospital Institute of Respira- tory Medicine. The initial recommendation was to ban e-cigs all together, he shares in a recent interview in Kuala Lumpur. But because there were "a lot of issues", which he declines to elaborate on, the committee decided on the next best thing: strict regulation. Last year, rural and regional develop- ment minister Datuk Seri Ismail Sabri Yaakob said the health ministry's ban on sales of vapes containing nicotine would kill the Malay-dominated industry. The minister made the comment after several groups lodged a police report over the issue. Dismissing the concerns of pro- vaping groups that legislating e-cigs as a pharmaceutical product will push up costs and make them inaccessible to smokers who want to quit, Dr Abdul Razak says that it's the same as buying medicine. The minimum age restriction for the sale of e-cigs, however, is still being debated. While he thinks having a global regulatory standard is ideal, it is not realistic as different countries have different local issues to contend with: "I'll be very happy if it's 21 but we are also looking at 18." He questions the reliability of Greek cardiologist Dr Konstantinos Farsalinos' claim that a large number of Malaysians have quit smoking because of vaping. The researcher, who will release his findings on the country's vapers later this week, told Sunday Star last month that the new survey shows a high cessation rate of smoking regular cigarettes among vapers here. The e-cig devices, he says, must comply with Malaysian Standard, a technical document that specifies the minimum requirements of quality and safety for voluntary use by the public. The committee is also seeking to review the Poisons Act 1952 to include e-cigs. In May, Health Minister Datuk Seri Dr S. Subramaniam announced that laws to regulate the vaping industry will be ready before the end of the year. The laws will involve all aspects of vaping and its products and accessories as well as distribution.

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