#134: Bollywood Smokers : Sanjay Dutt

He is controversies’ favorite child. From drug abuse at a young age to being involved for illegal possession of weapons, Sanjay Dutt has experienced all. His addiction to nicotine was so high that even during his earlier jailterm, he was allowed to puff cigarettes. This time the Munnabhai star was refused an electronic cigarette at the Arthur Road jail, where he is currently lodged.

#133: City Council votes to regulate e-cigarette sales in L.A

Calling it a potential health risk and a gateway to tobacco use, the Los Angeles City Council on Wednesday voted unanimously to regulate the sales of e-cigarettes and other "vaping" devices.

The new law puts electronic smoking devices in the same category as tobacco products, subjecting their sales to the same restrictions. It bans sales from street kiosks, ice cream trucks and self-service displays, and requires retailers to obtain a license before selling the products.

Parallel legislation under city consideration would ban the use of e-cigarettes in the same places that tobacco is prohibited, including restaurants and parks. Sales of e-cigarettes to minors are already banned under state law, and 59 California counties and cities, including Glendale and Burbank, require a license to sell e-cigarettes.

"It's important to protect young people from this deadly habit and to protect people from second-hand smoke," said Councilman Paul Koretz, who pushed the ordinance.

The battery-operated devices look like cigarettes and use heat to vaporize a liquid, some containing nicotine and fruit and candy flavorings. Users inhale the vapors and expel them, much the same as smoking tobacco.

Retail sales of the devices are expected to double this year to $1.7 billion, and e-cigarettes could outsell their tobacco counterparts within a decade, Dr. Jonathan Fielding, Los Angeles County's health director, said in a morning press conference. Use of vaping devices among high school students doubled in 2012 to 10%, according to a recent study by the national Centers for Disease Control and Prevention.

Though studies on the health impacts of vaping have been inconclusive, some of the devices contain harmful substances such as formaldehyde, chromium and lead, Fielding said.

Council members said it was better to err on the side of caution and take action. The U.S. Food and Drug Administration does not regulate the devices.

"It's a very sinister approach to a very sinister product," said Councilman Mitch O'Farrell, who wrote the action to regulate use of e-smoking devices. "We don't want to wait for the feds to do something."

School principals told the council that some of their students are loading e-cigarettes with marijuana cartridges and using the devices to smoke pot at school. Several speakers applauded the council's action, including Marlene Gomez of the American Lung Assn.

Gomez said manufacturers, some with ties to tobacco companies, are marketing the devices to children. "Many products are being produced that are candy-flavored or fruit-flavored, including Cap'n Crunch and Fruit Loops,'' she said.

No one spoke publicly in opposition to the ordinance. But the National Assn. of Tobacco Outlets submitted a letter to the council suggesting that city action was premature because the FDA is poised to issue its own regulations.

Thomas A. Briant, the association's chief legal counsel, also called into question the accuracy of the CDC survey on high school students who use e-cigarettes because he said it counted as a user anyone who had used the product even once.

Supporters of vaping say e-cigarettes can help tobacco smokers quit and are a safer alternative to traditional cigarettes. Adam Phramany opened Vape Star in Koreatown three months ago and says he's helped several customers kick the habit.

"I hate smoking in general and hate second-hand smoke,'' he said. "But I've witnessed first hand that most of my friends who started vaping quit smoking completely."

He thinks the vaping industry takes an underserved knock when government officials equate e-cigarettes with tobacco.

"I wouldn't say it's a healthier alternative but it's a smarter alternative because there is no tobacco involved,'' he said.

courtsey - http://www.latimes.com/local/la-me-1205-e-cigarette-regs-20131205,0,7451459.story#axzz2mcxuDt6h

#132: Breaking News: New study shows no risk from e-cigarette contaminants

Here is the post of the press release at CASAA's main blog (same content as above link, but with a link to here for discussion -- so a better choice if you want to share the press release).]

CASAA is delighted to announce that the first research study funded by the CASAA Research Fund (thanks to all of you who donated to that!) has been released.  The study, by Prof. Igor Burstyn, Drexel University School of Public Health, is available at the Drexel website, here (pdf).  Burstyn reviewed all of the available chemistry on e-cigarette vapor and liquid and found that the levels reported — even in those studies that were hyped as showing there is a danger — are well below the level that is of concern.

And that assessment applies to the vaper himself.  The exposure to bystanders is orders of magnitude less and of no concern at all.

The paper is technical, of course, but I believe it does a great job of communicating for readers at many levels.  It puts the results in very clear and useful terms — exactly what policy makers need for making decisions.

For the first time, we have a definitive study that can be used to respond to claims that contaminants in e-cigarettes are dangerous and that there is a hazard to bystanders that calls for usage restrictions.  Existing individual chemistry studies have been difficult for anyone other than an expert to understand (which is why we gave a grant to an expert to understand them!), and a naive interpretation of individual studies (just reading what the authors editorialized about their results) gave the impression of “dueling studies”, with some showing a problem and some not.  While many THR advocates made an effort to make sense of and use the existing literature, it was almost impossible to do so effectively.  Burstyn’s analysis solves that problem and shows there is no duel:  All of the studies, including the “bad” ones, show that there is no worry.

I cannot overstate it:  This is a game-changer for anyone trying to respond to misinformation about the hazards of e-cigarettes.  Before we had an apparently contradictory mess on this topic.  Now we have clarity.

I have to say that I am genuinely surprised that the results are quite so definitive, and I assume that will be true of anyone else of was seriously trying to assess the risks, rather than just cheerleading.  We were all confident that the risks were minimal, but we could not previously reach a (good news) conclusion as strong as the one in the paper.

The list of key conclusions in the paper:

• Even when compared to workplace standards for involuntary exposures, and using several conservative (erring on the side of caution) assumptions, the exposures from using e-cigarettes fall well below the threshold for concern for compounds with known toxicity. That is, even ignoring the benefits of e-cigarette use and the fact that the exposure is actively chosen, and even comparing to the levels that are considered unacceptable to people who are not benefiting from the exposure and do not want it, the exposures would not generate concern or call for remedial action.
• Expressed concerns about nicotine only apply to vapers who do not wish to consume it; a voluntary (indeed, intentional) exposure is very different from a contaminant.
• There is no serious concern about the contaminants such as volatile organic compounds (formaldehyde, acrolein, etc.) in the liquid or produced by heating.  While these contaminants are present, they have been detected at problematic levels only in a few studies that apparently were based on unrealistic levels of heating.
• The frequently stated concern about contamination of the liquid by a nontrivial quantity of ethylene glycol or diethylene glycol remains based on a single sample of an early technology product (and even this did not rise to the level of health concern) and has not been replicated.
• Tobacco-specific nitrosamines (TSNA) are present in trace quantities and pose no more (likely much less) threat to health than TSNAs from modern smokeless tobacco products, which cause no measurable risk for cancer.
• Contamination by metals is shown to be at similarly trivial levels that pose no health risk, and the alarmist claims about such contamination are based on unrealistic assumptions about the molecular form of these elements.
• The existing literature tends to overestimate the exposures and exaggerate their implications.  This is partially due to rhetoric, but also results from technical features.  The most important is confusion of the concentration in aerosol, which on its own tells us little about risk to heath, with the relevant and much smaller total exposure to compounds in the aerosol averaged across all air inhaled in the course of a day.  There is also clear bias in previous reports in favor of isolated instances of highest level of chemical detected across multiple studies, such that average exposure that can be calculated are higher than true value because they are “missing” all true zeros.
• Routine monitoring of liquid chemistry is easier and cheaper than assessment of aerosols.  Combined with an understanding of how the chemistry of the liquid affects the chemistry of the aerosol and insights into behavior of vapers, this can serve as a useful tool to ensure the safety of e-cigarettes.
• The only unintentional exposures (i.e., not the nicotine) that seem to rise to the level that they are worth further research are the carrier chemicals themselves, propylene glycol and glycerin.  This exposure is not known to cause health problems, but the magnitude of the exposure is novel and thus is at the levels for concern based on the lack of reassuring data.

It is worth expanding on the observation about propylene glycol and glycerin a bit:  While there is no affirmative reason to believe that the level of exposure experienced by vapers is hazardous, we have never before had a situation where millions of people had such a high level of exposure.  Thus it is worth gathering data on what happens, just to make sure there is no small subtle effect.  This contrasts with the levels of the much-hyped contaminants, which pose no concern at all.  It is also important to remember that this refers to the vaper herself; there is no such caution for bystanders, who have far far lower levels of exposure.

This paper should immediately become a central point in all political advocacy to stop anti-e-cigarette regulations, as well as trying to encourage smokers to adopt THR.  The key talking point that should be used is this (my words, not Burstyn’s):

The only expert review of all of the studies found that there was no risk from the chemicals to vapers, let alone bystanders.  This took into consideration the studies that you are referring to [note: assuming this is being used as a rebuttal to some claim of chemical hazards].  Indeed, even the results of the studies that have been used to generate alarm represented levels of chemicals that were too low to be of concern.

For those of you who have any comments for the author, particularly peer review (or even non-peer review) comments for improving on the working paper before it is submitted to a journal[*], please use the comments section of this post.  The author has agreed to monitor one page (this one), but will probably not see it if you post a comment at another blog, on ECF, etc.

[*Footnote: To head off a concern I have heard a few times, no, there is not a problem with the author releasing a working paper before submitting to a journal.  A handful of medical and general-science journals -- those that are trying to sell copies as if they were a glossy magazine -- like to have "exclusives" of previously secret studies (which, by the way, is why they publish far more papers that are shown to be wrong than do more serious journals).  Serious science journals generally prefer that the paper is circulated and commented on before they are asked to deal with it.  Indeed, in several of the more serious sciences (public health will catch up in a few decades -- perhaps), working paper versions are considered the key source of scientific communication, and the eventual appearance in a journal is more of an afterthought and happens long after everyone has already read the paper.  Real peer review is what starts now (here) when every interested expert can read and comment, rather than at a journal where a couple of people with their limited knowledge are the only ones reviewing it.

[Of course, that knowledge does not help you if you are dealing with people who do not understand how science works and are not likely to listen long enough to learn.  There will be retorts of "that is not a peer-reviewed publication" (which is actually not true -- it was reviewed before the author released it).  Your best talking point in response to that is something like, "So are you saying that in a few months, when the paper appears in a journal, you will agree that it is all correct and change your position?"  If you are responding to someone who claims to be an expert, you can add "So, why don't you just review it like other expert readers have done, or are you admitting that you are not expert enough to do so?"

#131: Obesity a greater risk than tobacco

Obesity, rather than tobacco-related disease, will affect more people's health in the future according to a new report released today by the Ministry of Health.

The Burden of Disease study was a culmination of many years of study into disability, disease and premature death.

The study measured "health loss" or how much healthy life was lost due to premature death, illness or impairment.

The Ministry said the data would help predict fatal and non-fatal health losses until 2016.

The report allowed the Ministry to see the "magnitude and distribution of causes of health loss for each demographic group" and helped to compare the relative impacts of different diseases, injuries and risk factors on health, the Ministry said.

Key findings included:

* Cancers and cardiovascular disease (heart attacks and stroke) each contributed 17.5 per cent of the health loss, followed by mental disorders (11 per cent), musculoskeletal disorders (9 per cent) and injury (8 per cent);

* Males have a 13 per cent higher rate of health loss than females; and

* Maori had about a 75 per cent higher rate of health loss than non-Maori.

It also revealed that data from 2006 showed people with a diet high in salt and saturated fat accounted for 11.4 per cent of health loss - more than tobacco at 9.1 per cent.

From that data, the Ministry predicted by 2016 obesity and a high body mass index would continue to cause more health loss, and tobacco would bring about less health loss because the number of smokers was dropping.

University of Otago, Wellington's Associate Professor Nick Wilson said improving the nutritional environment for New Zealanders should therefore be a high priority for the Government.

"Fortunately, this can be done in ways that might also save health costs such as by taxing sugar in soft drinks, and regulations that limit maximum salt levels in high-salt processed foods," Professor Wilson said.

As part of the report, the Accident Compensation Corporation (ACC) said health loss from injury - the fifth highest cause of health loss - robbed New Zealanders of more than 76,000 years of healthy life in the 2006 calendar year alone.

The report added a new dimension to their understanding of the impact that injuries had on the lives of New Zealanders, ACC's general manager of Insurance and Prevention Services John Beaglehole said.

ACC key findings:

* males account for nearly three-quarters of injury-related health loss;

* the leading causes of injury-related health loss are self-inflicted and transport-related injuries;

* Maori experience twice the rate of injury-related health loss of non-Maori, with particularly higher loss from transport-related, self-inflicted and interpersonal-violence-related injuries;

* alcohol is likely to be involved in a quarter of all injury-related health loss;

* for children, injuries are the third highest cause of health loss; and

* one third of injury-related health loss results from traumatic brain injury and spinal cord injury, most of which is due to transport-related injuries.

#130: Knife-wielding robber asked victim for a cigarette

A MAN was threatened with a knife by a robber after he refused to give him a cigarette.

The incident happened at School Lane, in Harlow Town Park.

According to police, the 24-year-old victim was in the park at about 4.50pm when he was approached by the mam who asked him for a cigarette.

When the victim refused to hand one over, the suspect produced a knife and threatened him.

The victim, who lives in the Harlow area, then handed over a cigarette.

The suspect is described as white, aged in his late 20s and of slim build. He is about 6ft tall with light blonde hair, blue eyes and was had a tanned appearance. At the time he was wearing a dark green shirt and purple trousers.