Tuesday, August 30, 2011

Statement from CASAA Advisor Bill Godshall at FDA MRTP Workshop

I’m Bill Godshall, founder and executive director of Smokefree Pennsylvania, a nonprofit organization that since 1990 has been advocating local, state and federal policies to reduce indoor tobacco smoke pollution, reduce tobacco marketing to youth, hold cigarette companies accountable, increase cigarette tax rates, fund tobacco education and smoking cessation services, inform smokers that all smokefree tobacco/nicotine products are far less hazardous alternatives to cigarettes, and in 2007 I convinced Senator Mike Enzi to amend the FSPTCA to require picture warnings on cigarette packs.
For disclosure, neither Smokefree Pennsylvania nor I have ever received any direct or indirect funding from any tobacco, drug or electronic cigarette company or trade association.
It is important to recognize that Section 911 and other provisions of Chapter IX of the FSPTCA only apply to: cigarettes, cigarette tobacco, RYO tobacco and smokeless tobacco products. Although the FDA has stated that it intends to propose a regulation to apply Chapter IX to all currently unregulated tobacco products, Section 911 does not apply to small cigars, large cigars, pipe tobacco, hookah/shisha tobacco, electronic cigarettes, e-liquid, tobacco skin cream, tobacco water and at least two dissolvable tobacco products....

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Friday, August 26, 2011

CASAA on YouTube

Check out CASAA's YouTube channel for videos on tobacco harm reduction, smokeless tobacco and e-cigarettes. If you have any videos you'd like to share, post a link in the comments area below, send us a link on Twitter or post them on our Facebook page!

CASAA on YouTube: http://www.youtube.com/user/CASAAmedia?feature=mhee

CASAA Testimony - FDA MRTP Workshop

FDA Workshop - Scientific Evaluation on Modified Risk Tobacco Products CASAA Public Testimony by CASAA Vice President Elaine Keller, CASAA Advisor Bill Godshall of Smokefree Pennsylvania, along with other tobacco harm reduction advocates.

The purpose of the public workshop is to discuss issues pertinent to the scientific evaluation of modified risk tobacco product (MRTP) applications. The workshop will feature 5 moderated panel discussions on the following topics:

  • Assessing the Potential Effects of MRTPs on Individuals and Populations
    • Benefit to Individual Tobacco Users
    • Impact on the Health of the Population as a Whole
  • Comparisons of MRTPs to other Tobacco Products
  • Modified Risk Claims for Reduced Substance Exposure
  • Consumer Perceptions of MRTPs
  • Post-Market Surveillance and Studies of Commercially Marketed MRTPs 

Read Elaine's presentation here:

Watch home video of presentations on Youtube: http://www.youtube.com/user/CASAAmedia#p/a/u/0/0XuSDCTRmT0

Recorded video will be posted here: http://www.fda.gov/TobaccoProducts/NewsEvents/ucm259201.htm

Read first-hand accounts on ECF forum here: 

Wednesday, August 24, 2011

Safe sex vs. Safe tobacco

By Kristin Noll-Marsh
Wisconsin Vapors Blog

In the 1980's, public health groups began campaigning for "safe" sex. These campaigns promoted the use of condoms to reduce exposure to HIV and AIDS and continue to be used today to promote reduced exposure to other dangerous and debilitating sexually transmitted diseases (STD).

Rarely are the public health benefits of reducing health risks via "safe" sex questioned, even though "safe" sex is a misnomer. A 2001 NIH panel of experts examined dozens of studies and found that proper and consistent condom use reduced the incidence of STDs by 18% to 92%, depending upon the disease in question. At best case, that still leaves an 8% health risk for "safe" sex practices. For the human papilloma virus (HPV) - which has been linked to cervical cancer, the fifth most deadly cancer in the world for women - the harm reduction is even less. 

In reality, condoms contribute to "safer" sex, but do not cause sex to be 100% safe. This does not stop public health groups from promoting "safe" sex to the public and the majority of us agree that it's better to be safer, even if it's not 100% safe. Millions are still spent promoting safe sex practices, even though STDs rarely result in death. In fact, it's reported that 80% of those infected with STDs are asymptomatic and not even aware that they are infected. The CDC reports that around 18,000 people with AIDS and approximately 4,000 women with cervical cancer die annually.

On the other hand, the CDC and other health groups report that "tobacco use" (or more specifically, smoking) causes 440,000 deaths annually in the U.S. (including the highly debated second hand smoke deaths.)  Compared to smoking deaths, mouth cancer, the main health warning for smokeless tobacco use, contributes to only 8,000 deaths annually. However, according to the National Cancer Institute, researchers have been unable to determine how many of those deaths are actually caused by smokeless tobacco use. Based on one 1981 study of female chew users in the southern U.S., the NCI reports that "users of smokeless tobacco are at four times the risk of developing oral cancer than non-users." More recent research shows that smoking actually causes twice the risk of oral cancers (compared to smokeless) and factors such as alcohol abuse and dual use of smoking and smokeless seem to have reduced the link to oral cancer caused by smokeless use alone even further. In fact, the scientific research overwhelmingly shows evidence that smokeless tobacco carries very little to no health risks, at or less than 1% compared to never-users.

In spite of knowledge of this widely known research and the ready acceptance of harm reduction practices for less lethal STDs, public health officials refuse to acknowledge the obvious potential health benefits of promoting harm reduction in the form of smokeless tobacco products.

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Tuesday, August 23, 2011

Electronic Cigarette Research Update

Can e-cigarettes help people stop smoking?

All clinical research to date has found that electronic cigarettes show promise in helping smokers become abstinent from smoking.  Camponneto, et al learned about e-cigarettes from two patients who stopped smoking and remained abstinent for more than 6 months after taking up an electronic cigarette.  The authors comment, “This is outstanding in consideration of the fact that this result was accomplished by highly addicted smokers who repeatedly failed professional smoking cessation assistance without the support of recommended nicotine dependence treatments and smoking cessation counseling.”

Bullen, et al conducted a randomized cross-over trial with 40 subjects and found that the product “alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette.” The findings by Darredeau, et al reported at the 12th SRNT Europe conference, suggest that regardless of nicotine content, electronic cigarettes may provide an effective means of relieving acute tobacco craving in at least some smokers.

Population surveys indicate that electronic cigarettes are much more effective than currently available smoking cessation treatments.  Heaver, et al, surveyed over 300 e-cigarette consumers and found that 79% were using the e-cigarette as a complete replacement for smoking, 17% had significantly reduced the number smoked, and only 4% still smoked as much as before. The most recent published survey by Etter and Bullen surveyed 3,587 subjects, median age 41, of which 2,850 used e-cigarettes with nicotine, and 112 used e-cigarettes without nicotine.  Among 2,896 daily users, 2,234 (77%) no longer smoked at all, and the median duration of smoking abstinence was 152 days.

Are e-cigarettes safe?

Tuesday, August 16, 2011

Dissolvable tobacco new to Colorado, but old questions arise

Star and Reynolds correct inaccurate claims about dissolvable tobacco products, CO Board of Health to hold public hearing August 17th.

“Hopefully, there will be people at the hearing who will tell us what the issues are,” said Dr. Chris Urbina, executive director and chief medical officer of the Colorado Department of Public Health and Environment. “There’s no data; it’s a fairly new product.” 
Only, dissolvable tobacco products are not new. Star Scientific of Glen Allen, Va., introduced the Ariva dissolvable tobacco lozenge in 2001 and Stonewall lozenge in 2003, and the products have been available in Colorado for awhile, said Sara Troy Machir, vice president for communications and investor relations.
“Actually, there is data on dissolvables,” she said. “I could send you five studies, done by people funded by NIH (National Institutes of Health), on toxins in dissolvables.” (Read what NIH calls "the first published chemical analysis of dissolvable tobacco" here

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Monday, August 15, 2011

American Lung Association continues to misrepresent smokeless risks

by Kristin Noll-Marsh
Wisconsin Vapers Blog
The ALA posted an article titled "Is There an Easy Way to Quit?" on it's web site today, which is filled with typically deceptive ANTZ tactics.

Making statements such as  smokeless tobacco has "28 cancer-causing agents" and "increases the risk of developing cancer" and that e-cigarettes contain "cancer-causing agents and toxic chemicals" found in anti-freeze is not only leaving out key information, it relies upon questionable "science" and sensationalism to deceive the reader....

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Wednesday, August 3, 2011

Reconsidering and Revising Terminologies and Definitions to Adapt to a Changing Tobacco, Nicotine, and Alternative Products Regulatory Environment

An Observational Piece

Several months ago in an observational piece about the critical role that science will be playing in terms of tobacco, nicotine and alternative product regulation, I indicated that I was planning on doing something concerning the increasing confusion over the various uses of words and terms in the tobacco, nicotine and alternative products environment. As with the other observational pieces I have done, this piece is designed to make some observations, to generate further discussion, and to hopefully initiate some new thinking.
The FDA's acquisition of regulatory authority over tobacco products (and it previous existing authorities over therapeutic nicotine replacement products), the importance of science in setting regulations, and the obvious fact that we are in a 'new era' of tobacco, nicotine and alternative product regulations, make it important at this juncture that we clearly define our terms and reconsider how we might best approach policy decisions in the coming months and years.

I have been in 'tobacco control' (I am not even entirely sure what that means in today's environment) for more than 30 years. In the early years it was relatively simple to use terms - it was a 'war' between two interests, good and evil. We in public health wore the white hats of course and the tobacco industry wore the black hats. The tobacco industry, later to be branded BIG TOBACCO, was relatively easy to define. We knew their deceitful and deceptive practices. We knew how extensive their influences were and the extent to which their money influenced decision- making. We knew that they worked hand in hand following well laid out strategies. We considered any one associated with tobacco, including tobacco farmers, retailers, advertisers etc. as a part of the tobacco industry. Today while these two extremes continue to exist there is a much larger 'gray' area that has emerged --- an area that often goes unrecognized by those who remain severely polarized and content on keeping the old ' tobacco wars' of the 80's and 90's alive....

Read Full Story> 

Monday, August 1, 2011

FTC reports indicate smokers finally getting the right message

The Consumer Advocates for Smoke-free Alternatives Association (CASAA), a tobacco harm reduction advocacy group, said that two encouraging reports released Saturday by the FTC may indicate that U.S. tobacco users are getting the message that smokeless tobacco products are up to 99% safer than smoking. Just as encouraging, they said, it seems that the tobacco companies are recognizing this trend and shifting their advertising dollars from high-risk cigarettes to these low-risk smokeless alternatives.

According to the reports, smokeless tobacco consumption has increased 3.6% from 2006 to 2008 (http://ftc.gov/os/2011/07/110729smokelesstobaccoreport.pdf) and smokeless tobacco advertising spending increased 55% during the same period. Additionally, nationwide cigarette advertising and promotional expenditures (http://ftc.gov/os/2011/07/110729cigarettereport.pdf) declined 20% from 2006 to 2008 and cigarette consumption declined by 8%.

CASAA is a non-profit, all-volunteer organization that encourages smokers to find an acceptable, low-risk smokeless alternative. The group said research clearly shows that public health would improve significantly if committed tobacco users were encouraged by health professionals to at least switch from smoking to smokeless tobacco or nicotine products if they cannot or will not quit.
“For over a decade, smokers have been given the scientifically untrue message that smokeless products are just as dangerous as smoking, because tobacco manufacturers are prohibited by law to tell the whole truth,” said Elaine Keller, CASAA's vice president. “They are required to place warnings on their packaging that the products ‘are not a safe alternative to smoking.’ While this is technically true, most people would consider a less than 1% health risk as quite safe compared to the smoking risks.”

Because of the federal law, tobacco companies are forced to focus on promoting smokeless use when you cannot smoke, rather than informing smokers of the lower health risks. Keller said CASAA has no such restrictions and has been informing smokers since 2009 that the science and research actually supports modern smokeless products as nearly risk-free.

“Anti-tobacco public health groups are so keen to stop all tobacco use, regardless of the health risk variances, that they refuse to acknowledge tobacco harm reduction practices, for fear that smokers will switch to much safer smokeless products rather than quit altogether,” Keller stated.

While overall cigarette consumption was down in 2008, the number of U.S. smokers has stalled at nearly 21% of the population. It seems these smokers cannot or will not quit using tobacco or nicotine in some form. Additionally, smoking among youths is increasing in some areas. Keller said CASAA is concerned with those smokers who have no intention of quitting tobacco use, potential new smokers and smokers who have not heeded the public health group’s “quit or die” message.

“To expect inveterate smokers to suddenly quit after 30 years of smoking or to believe that youths will not continue to experiment with smoking and become addicted is simply dangerous wishful thinking,” she said. “And as long as these folks believe that smokeless products are no safer than smoking, they will just continue to smoke or choose to start smoking over less dangerous products. So, is that the message we really want to be sending?”

Keller said that the numbers in these reports are a good sign that the message may be getting out through the efforts of tobacco harm reduction advocates such as CASAA and the group hopes the trend continues, in spite of recent efforts by anti-tobacco groups to discredit tobacco harm reduction advocates.

“In this age of internet fact-finding, the truth will always come out. Smokers have heard the message from anti-tobacco groups that smoking is bad for them, yet they are still not quitting. Now they seem to be hearing our tobacco harm reduction message and making the switch. More smokers need to hear the truth that their only options are not quit or die.”

Media Contact:
Elaine Keller
182 St Francis st #300
Mobile AL, 36602