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Mountain Vapor Blog

Welcome to the blog area of our site where we hope to keep you updated on the trends of the e-cigarette industry as well as product reviews.

Science lesson: The absurdity of “n deaths per year” and “leading preventable cause” claims about smoking.

by Carl V Phillips

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“Third-Hand Vapor” Precautions Are Not Justified. Guest Post by Dr. Roberto Sussman


BR note.  Readers of this blog know that anti-tobacco activists greatly exaggerated the risks of second-hand smoke (here and here). 

Unfortunately, the scaremongering has expanded to include third-hand smoke (discussed here), third-hand smokeless (here) and third-hand vapor (here).   

Two weeks ago another exaggerated “third-hand vapor” study was published by University of California activists.  For a perspective on this study, I am happy to introduce Dr. Roberto Sussman, a scientist (physics) in the Institute for Nuclear Research at the National Autonomous University of Mexico. Dr Sussman is also the director of Pro-Vapeo México AC, an all consumer non-profit association representing Mexican vapers and consumers of non-combustible nicotine delivery products, and an active member of INNCO.


“Third-Hand Vapor” Precautions Are Not Justified
By Dr. Roberto Sussman 

A recently published article (abstract here) seems to suggest potential health hazards from what could be called “third-hand vapor” in parallel to analogous studies on third-hand smoke. Specifically: the estimated exposure to electronic cigarette exhaled aerosol residues (ECEAR) deposited on surfaces and fabrics in rooms that are adjacent to a vape shop.   While it is worrying that the study of such extremely minute potential exposures to vapor residues may contribute to justify extensive vaping bans, the present comment only deals with strictly scientific (not political or activist) issues. Specifically, the following three issues are worth commenting:

(1) E-cigarette vapor vs PM2.5.The article provides some background on possible health hazards from e-cig vapor. The following texts appear in the introductory section:

Significant amounts of 1,2-propanediol, glycerin, nicotine and PM2.5 particles were present indoors during 2 hours of vaping. Moreover, an indoor air quality study showed that a large room with active EC users contained PM2.5 at concentrations that were higher than in hookah cafes and bars that allow cigarette smoking. .  

The text conveys a sense of alarm, as it alludes to “PM2.5”  (particulate matter of diameters smaller than 2.5 microns) allegedly present in the e-cigarette aerosol. These particles are found in aerosols produced by combustion mechanisms, for example in air pollution or tobacco smoke. However, the text quoted above hints the existence of an equivalent concern on health effects from exposure to PM2.5found in environmental e-cigarette vapor.  This seems to be completely unwarranted, since the “particles” in electronic cigarette exhaled aerosol are liquid droplets, not proper particulate matter, even if “particle” counts and diameters are of the same order of magnitude as in environmental tobacco smoke. This is clearly stated in various reliable sources (for example, “Public Health Consequences of E-Cigarettes: a Consensus Report”,  National Academies of Sciences Engineering and Medicine, see page 72 of the report here.)

I wonder why an article whose task is to look at potential exposures to pollutants in electronic cigarette vapor does not mention, as relevant background information for the readers, the fact that “particles” in the EC aerosol are chemically distinct (liquid droplets) from solid PM2.5 found in second hand smoke. It is an important fact, yet it is omitted. 

(2) Accumulated fabric exposures are not realistic exposures in humans. The article mentions the possibility of potential exposure to toxicants by ingestion or dermic contact with ECEAR (electronic cigarette exhaled aerosol residues) deposited in cotton towels, paper towels and air filters.  However, no actual human exposures are measured or even estimated; only short and long term accumulated concentrations of deposited ECEAR in fabrics and filters placed in various fixed positions that can be in the path for continuous ECEAR deposition, for short and long term periods specified in Table 1. The results of this accumulated deposition are given in figures 2 and 3 in terms of dimensionless  quantities proportional to “1 ng (nanogram = 10-9 gm) per 1 gm of a fabric”, analogous to ppb (particle per billion) figures for concentrations in a gaseous medium.  To estimate actual human exposures to ECEAR, it would be necessary to estimate the time and fabric surface area in which human subjects are actually exposed (under realistic assumptions) to these accumulated concentrations. Under normal circumstances exposure times to pollutants by dermic manipulation or ingestion of these items is not continuous nor prolonged: people may ingest or dermically manipulate these items for brief intermittent time periods and along reduced mouth or skin contact surfaces. 

The accumulated deposits of nicotine, alkaloids and nitrosamines can only be translated into actual human exposures under the extreme maximalist assumption of continued ingestion or dermic interaction for the same period in which the toxicants accumulated in the filters and fabrics that were placed to collect the substances in fixed spots. Realistic total human exposure will be much less because the actual ingestion or dermic interaction is short timed and intermittent and contact or mouthed surfaces contain few grams of fabric.  As an example, the article reports that

“After 35 days in the field site, a cotton towel collected 4.571 micrograms of nicotine. If a toddler mouthed on 0.3 m2 [squared meters] or about 1 squared feet of cotton fabric from suite #1, they [sic]would be exposed to 81.26 mg [micrograms]of nicotine”. 

From Table 1 and figure 2B this corresponds to sample SF35D, the quantity in the figure is 4571 ng per fabric gram, though 0.3 m2 is not a square foot but 3 square feet (3000 cm2). The reported area of 1 gm of cotton towel is 13.4 X 12.5 = 168.75 cm2, so that 3000 cm2 corresponds to 3000/168.75 = 17.8 gm of fabric, which multiplied times 4.571 mg per fabric gram yields the reported 81.25 mg of exposure to nicotine. However, this estimation is extremely unrealistic:  a toddler does not mouth a cotton towel for a long time, and 3 square feet is a huge fabric surface for a toddler to mouth! To understand how the authors obtained this quantity, we assume a constant deposition rate for 35 days in which the fabric sample SF35D was exposed to ECEAR. This means 135 ng per 1 gm of fabric per day, hence the total deposition for 0.3 m2 is 2.314 mg per day, and thus 81.25 mg of nicotine just exactly corresponds to 81.25/2.314 = 35.11 days of exposure to a continuous 35 days of ECEAR deposition. Hence, the authors assume that the 81.25 mg exposure to nicotine by a toddler mouthing 3 square feet is equivalent to a continuous 35 days exposure to nicotine by a 3 square feet surface area of the cotton fabric. This is wholly unrealistic and highly exaggerated; toddlers don’t mouth cotton fabric in this manner.   

If we follow the authors’ estimate of nicotine exposure but apply more realistic toddler-mouthing times and fabric surface area, we get far smaller exposure figures. For example, a toddler mouthing only 1 gm of fabric (168.75 cm2) for one hour per day – still a gross exaggeration – is exposed to 5.41 ng of nicotine (130 ng per day/24). For 35 days we get 189.35 ng, not the suggested 81,250 ng. 

Moreover, the assumption of one hour contact with 1 gm of fabric every day during for 35 days is still unrealistic. Under normal conditions the exposed items (towels and filters) do not sit statically in homes, shops and offices for such extended time periods, and their chemistry will change by interaction with multiple external agents, necessarily altering the deposited ECEAR amounts.  Filters are designed to trap pollutants, thus it is not surprising that they contain more ECEAR, but are touched and manipulated only for maintenance or for normal control/replacement operation (which takes seconds). Paper towels are disposable and cotton towels are periodically washed, so 81.25 mg of nicotine will never accumulate.

As far as I am aware, the tobacco-specific nitrosamines (TSNAs) are the most worrying compounds in ECEAR, yet the detected exposure by fabrics and filters collecting ECEAR is really minute. Even long term, it is below 15 ng per 1 gm of cotton fabric, or about 0.42 ng per day. Assuming daily exposure comparable to this deposition rate and one hour of dermic manipulation of the towel yields a very minute exposure to TSNAs of 0.0175 ng.  I doubt that such a small hazard signal can be separated from the background noise.    

(3) Does exhalation of large clouds release more nicotine?. The article states that 94-99% of nicotine is retained by the vaper (citing reliable sources), yet the authors mention that 

“... the extent of nicotine exhalation depends on the user’s propensity to produce clouds of aerosol. In our real world study, nicotine generated by vape shop occupants reached suite #1 and contributed to ECEAR"   

It is not evident that exhaling larger clouds releases more nicotine into the environment. True, a large cloud contains more mass of aerosol, and thus more nicotine, but exhaling large clouds also requires deeper inhalation, which would likely produce larger nicotine deposition in the respiratory system. It is not obvious that this could compensate the larger mass of exhaled aerosol + gas phase.  

Excessive usage of the precautionary principle. The article concludes with this statement:

“Building codes will need to be developed and enforced to protect those who do not wish to be exposed to ECEAR. Vape shop air quality is not currently regulated nor has it been thoroughly studied. Regulatory agencies should exercise authority over malls to ensure that employees and tenants do not receive unwanted exposure to EC aerosols and its residues”.

The results and actual measurements in this report were from exposures to static fabrics and filters, not realistic exposures to real people.  So the authors’ recommended regulations are excessive and unfounded.




Original author: Brad Rodu
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A subtle tobacco control self-contradiction lie, re FDA pumping cigarette stock prices

by Carl V Phillips

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All people like better products. Teenagers are people. Therefore….

by Carl V Phillips

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Vaping Plays a Role in Young Adults’ Low Smoking Rate


The anti-tobacco Truth Initiative tweeted that the smoking rate among young adults (18-24 year old) in the U.S. is “just 10.4%,” based on the 2017 National Health Interview Survey (NHIS) (here). 

But the Initiative didn’t tell the whole tobacco “truth.”  Using the same NHIS data, I prepared the chart at left which confirms that smoking is way down among young adults, continuing a decline I reported previously (here).  Nearly 85% of young adults have never smoked, including 2.7% who currently vape, 13% who tried e-cigarettes and 69% who never used either product. 

Among the 5% who are former smokers in this age group, over half were current vapers or had tried vaping products.  Even more impressive, 7 out of 10 current smokers were either current vapers or had tried e-cigarettes, meaning they could eventually make the switch to smoke-free.

Advocates of greater tobacco control make a specious boast when they celebrate lower smoking rates while ignoring the positive impact of vaping. 



Original author: Brad Rodu
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Letter to WHO’s DG against prohibition and for risk-proportionate regulation

Dr Tedros Adhanom Ghebreyesus
Director General
World Health Organisation
Avenue Appia 20
1202 Geneva

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Innovation for Consumers: E-cigarettes and novel tobacco products – Part of the problem or part of the solution?

September 5th, 2018

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Let’s try to get our criticisms right, shall we? (More on the recent “vaping causes heart attack” study)

by Carl V Phillips

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Slight Teen Vaping Increase and A Continued Smoking Decline in 2017



Despite the rhetoric, there is no “Juul epidemic” among high school students.  

The purported epidemic has been widely cited in the media.  Just last week, an article in the New England Journal of Medicine (here) asserted that “use of these products is rampant among young people.”  The authors based their claim on “Media stories about Juul … [that] highlight anecdotal reports from students, parents, teachers, and school superintendents.”  This falls far short of normal journal standards.  (The NEJM commentary also included the confounding contentions that “Pod mods are easy to conceal from authority figures” and “Juul vaporizers measure 93.98 cm,” or an astounding 37 inches.)

Campaign for Tobacco-Free Kids president Matt Myers has been a cheerleader for the mythical epidemic: “Everyone was asleep at the switch.  And by the time we woke up, we had an epidemic on our hands.  I've never seen a tobacco-related product spread across this country as fast among young people as this product.” (here)    

In fact, no one else has seen it.  Claims of a Juul epidemic are baseless.  Government data show that while e-cigarette experimentation increased among American high school students from 2011 to 2015, the year Juul was introduced, vaping stabilized in 2015 and smoking rates continued to drop. 

In 2017, 1.15 million (7.7%) American high school students were current (past 30 days) e-cigarette users, 556,000 (3.7%) smoked, and 632,000 (4.2%) used both products, according to the Centers for Disease Control and Prevention’s 2017 National Youth Tobacco Survey (NYTS).

Comparing those numbers to 2016 (here), smoking and dual use declined marginally, by about 0.2 percentage point, while vaping increased by 0.5 point. 

While Juul sales may have surged, neither they nor any other e-cigarette brand produced a youth vaping epidemic.


*The apparent spike in e-cigarette use increased among high school students from 2013 to 2014 was partially due to what researchers term an artifact, related to a change in the survey design.  Questions about e-cigarette use were bundled with those for “other” tobacco products until 2014, when they appeared in a separate section, after cigarettes, cigars and smokeless tobacco.


Original author: Brad Rodu
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Dual use and the arithmetic of combining relative risks

by Carl V Phillips

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FDA Tobacco Center Exaggerates Number of Youth Tobacco Users


The FDA Center for Tobacco Products published an inaccurate graphic in June (the “Most Used Tobacco Products in 2017” Venn diagram here) and tweeted it on August 8 (here), asserting that 2.1 million U.S. middle and high school students in 2017 were current (past 30-days) users of e-cigarettes, 1.4 million were current cigarette smokers, and 1.3 million were current cigar smokers. The graphic, which mischaracterized data from the 2017 National Youth Tobacco Survey, would lead most to believe that nearly 5 million youth used the three products. That conclusion would be grossly off the mark.

In fact, NYTS data indicate there were only about 3.3 million current users of these three products, with a 40% overlap. (This is not surprising, as research shows that use of one tobacco product is associated with use of others here, hereand here.)

The next chart breaks out exclusive and multiple users of e-cigarettes, cigarettes and cigars, based on my analysis of the 2017 NYTS data. 



Over 50% (1,125,000) of the 2.1 million e-cigarette users didn’t smoke at all, 22% smoked both cigarettes and cigars (red font), 15% smoked cigarettes, and 12% smoked cigars (yellow font).  These distinctions are important, as they are associated with different levels of e-cigarette use, shown in the following chart. 



A large majority (74%) of exclusive vapers used e-cigarettes infrequently (1-5 days in the past month); only 12% reported frequent use (20-30 days).  Vapers who smoked cigarettes or cigars were much more likely to be frequent e-cigarette users (20-21%); frequent use was 38% for users of all three products.  

Using a misleading graphic, the FDA exaggerates the number of teens who use tobacco. 


Original author: Brad Rodu
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A balanced view of ad hominem judgments

by Carl V Phillips

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UK Favors E-Cigarettes, Scores Major Smoking Reduction; Anti-Vaping Ireland Sees Smoking Rates Unchanged


There is, as I have noted (here), a stark contrast between British government and medical authorities’ support for e-cigarettes and vaping, and the demonization of same by most of the American public health community.  A similar clash of positions exists between the United Kingdom and Republic of Ireland.

The British blogger Dick Puddlecote observes (here) that the UK and Ireland are “nearest cultural neighbours, so closely aligned [that] we that we don't even enforce passport requirements between the two countries.  The British and the Irish are about as good a comparison for ecological purposes as there can possibly be.  And, as [British Member of Parliament Sir Kevin] Barron said, the only difference between UK policy and Irish policy is that over here our government cautiously welcomes new nicotine products whereas in Ireland they don't.”

Puddlecote underscores: “In the UK smoking rates have nosedived, while in Ireland they have barely shifted.”

I have verified that statement by reviewing government data.  The UK’s Office for National Statistics reported that smoking prevalence was 20% in 2012, after stalling during the six previous years (here).  However, between 2012 and 2017, the rate fell to 15% (here). 

Ireland started out in 2012 at nearly the same prevalence, 22% (here).  But five years later it was unchanged (here), according to the Ireland Department of Health.

The difference in smoking reduction in these neighboring countries is extraordinary.  As Puddlecote observes, “this deserves more attention…You just have to wonder why the tobacco control industry and other politicians, both sides of the Irish Sea, have been so silent about it.”

Indeed.   



Original author: Brad Rodu
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South Africa draft tobacco Bill – protects cigarette trade and denies smokers options to quit

August 8th, 2018

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More Vaping Facts, Not All Good, from 2017 CDC Data


CDC and other U.S. government agencies rarely publish straightforward numbers and conclusions about adult e-cigarette use; their focus is usually on underage use.  Last month, by re-analyzing the federal data, I demonstrated that the number of American vapers declined in 2017 (here); following are additional insights.

As seen in the table below, the number of every-day e-cigarette users increased between 2014 and 2016.  However, in 2017 the number dropped by almost a quarter-million.  The proportions of current, former and never smokers in 2014 were 50%, 46% and 4%.  By 2016 the proportions were 32%, 58% and 10%, indicating that more every-day e-cigarette users were former smokers.  In 2017, the proportion of former smokers inched up again: 32%, 60% and 8%.

.nobr br { display: none } td { text-align: center}
Number (in millions) and Prevalence (%) of Every-Day and Some-Day E-Cigarette Use in the U.S., 2014 to 2017





Every-DaySome-DayAll




20142.71 (1.1%)6.20 (2.6%)8.91 (3.7%)
20152.94 (1.2%)5.40 (2.2%)8.34 (3.4%)
20163.03 (1.2%)4.77 (2.0%)7.80 (3.2%)
20172.79 (1.1%)4.09 (1.7%)6.88 (2.8%)
 
The number of some-day e-cigarette users declined in 2017 for the third consecutive year, to 4.09 million – over 2 million fewer than in 2014.  Most were current smokers in all years, but the proportions shifted:  In 2014, they were 80%, 12% and 8% for current, former and never smokers.  By 2016, the proportions were 68%, 18% and 14%; and in 2017, they were 62%, 15% and 23%.

In 2017, there were 1.17 million never smokers who were current vapers, and 80% of this group (933,000) were using e-cigarettes some days.   The vast majority of some-day users were either 18-24 years of age (68%), or 25-34 (23%), suggesting that vaping is displacing smoking in these younger groups.

It is unfortunate that the number of daily and some-day U.S. vapers is declining, as the facts demonstrate that tobacco harm reduction can only be successful if smoke-free tobacco consumption increases among inveterate smokers.


Note: Thanks to Bill Godshall for requesting these additional insights.


Original author: Brad Rodu
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More Proof from FDA Population Data Showing E-Cigarettes As Popular Quit-Smoking Aids


While the number of American vapers declined over the last three years (as I reported here), e-cigarettes were still far more popular quit-smoking aids than medicinal nicotine or other drugs, according to researchers at the University of California San Diego (here).

Tarik Benmarhnia and colleagues used information from Waves 1 and 2 of the FDA-funded Population Assessment of Tobacco and Health (PATH) Study to evaluate “the influence of [e-cigarettes] and pharmaceutical cessation aids [varenicline, bupropion and nicotine medicines, NRT] on persistent abstinence (≥30 days) from cigarettes, and reduced cigarette consumption” during the period 2013 to 2015.  They concluded:

“Our results indicate that [e-cigarettes] are a more popular choice than approved pharmaceutical products as a smoking cessation aid among US quit attempters, over three quarters of whom were daily smokers.  In the future, as [vapor] products continue to evolve to make nicotine delivery more similar to that obtained from a cigarette, it is possible that they may play a bigger role in assisting smokers to quit combustible tobacco.”

This study confirms my research group’s earlier analysis of Wave 1 PATH data: E-cigarettes are among the most commonly used quit aids for American smokers, and they are the only aid more likely to make one a former smoker (i.e., a successful quitter) than trying to quit cold-turkey (here). 



Original author: Brad Rodu
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CDC Data Shows That E-Cigarette Use Declined Again in 2017


About 6.9 million Americans were current users of e-cigarettes in 2017, according to data in the 2017 National Health Interview Survey, the source for CDC national smoking estimates.  That’s a million fewer vapers than the prior year, and over two million fewer than in 2014, the first year NHIS surveyed for vaping.    

The number of current vapers who were former smokers had increased through 2016, but dropped in 2017, from 2.62 to 2.3 million.  This is not good news for tobacco harm reduction.

Another fascinating detail from 2017 is that 1.17 million never smokers currently used e-cigs, and over two-thirds of those were 18-24 years old.  This may be an extension of the recent increase in high school vaping (here), but it’s important to note that smoking in this age group is way down (here). 

Vaping has been portrayed as a menacing new epidemic by tobacco and nicotine prohibitionists in government and elsewhere.  It now appears that the misinformation in their anti-vaping messages has been effective (here).  The number of vapers has tragically declined. 

Original author: Brad Rodu
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FDA: You Can Run Models, But You Can’t Hide Facts About Smokeless Tobacco


In a recent New England Journal of Medicinearticle, FDA researchers went to great lengths to conceal the fact that smokeless tobacco (ST) use has an entirely negligible impact on life expectancy.

The article, “Potential Public Health Effects of Reducing Nicotine Levels in Cigarettes in the United States,” (here) by Benjamin Apelberg and colleagues, was the centerpiece of FDA Commissioner Scott Gottlieb’s March 15 announcement of a radical nicotine reduction rule for cigarettes.  Drawing from the research, an FDA press announcement (here) declared that if cigarettes were minimally- or non-addictive by 2020, approximately 5 million additional adult smokers would quit smoking within just one year; only about 1.4 percent of the U.S. adult population would smoke cigarettes by 2100, in part, because more than 33 million people would avoid becoming regular smokers; more than 134 million years of life [would be] gained among the U.S. population.

While it is entirely unclear how nicotine reduction would produce the first two results, there is a fundamental flaw in Apelberg’s model that mainly affects the third, years-of-life, claim.  Correcting for that error, the model would likely confirm that ST products are nearly risk-free.

Apelberg estimates excess deaths among smokers by linking participants from National Health Interview Surveys (NHIS, 1997-2004) to the National Death Index (NDI) through 2006.  He also estimates deaths among users of ST, but uses an entirely different dataset – smokeless users who were enrolled in 1982 in the American Cancer Society Cancer Prevention Study II.

Apelberg’s use of two data sets -- NHIS for smokers and CPS-II for ST users – violates a basic rule of modeling: all inputs should be from the same or similar sources.  NHIS should have been used for analysis of both groups.  That was the procedure, for example, when Michael Fisher and colleagues used NHIS and NDI to produce a stable estimate for all-cause mortality among smokers and ST users (here). 

Apelberg may have used CPS-II because it shows that ST users’ mortality rate was 18% higher than that of never tobacco users.  Had he used NHIS, he would have had to acknowledge that smokeless users had no significant risks, as Fisher documented only a 5% excess that was not significant (HR= 1.05, CI = 0.90 – 1.23) (here).

The FDA analysis was biased through the use of exaggerated risks from an American Cancer Society study that has never been evaluated by independent researchers (here, hereand here).  In this way, the FDA hid the negligible health impact of ST use.

A letter I submitted to the New England Journal of Medicine describing the flaw was not accepted.




Original author: Brad Rodu
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Weight Wisdom: Avoid Extremes, But Being “Over” May Have Benefits


A new CDC-released study by National Center for Health Statistics’ Dr. Katherine Flegal and colleagues (here) confirms results from her groundbreaking 2005 report (here): compared with people of normal weight (BMI = 18.5 to less than 25), those who are overweight (BMI greater than 25 but less than 30) have a lower mortality rate.  Higher mortality rates are seen with obesity (BMI greater than 30) and underweight (BMI under 18.5).    

Applying weight-based mortality rates to the U.S. population, Flegal estimated in 2005 that overweight resulted in 82,094 fewer deaths, and a significant number of excess deaths were associated with obesity, a (n = 111,909) and underweight, (n = 33,746). 

As I noted in this blog five years ago (here), Flegal’s conclusions are consistent with those of many other scientific studies. 

I have long had a professional interest in population research on weight and health. In 2004, I published the first study to show that Swedish men who quit smoking by switching to snus avoided the weight gain usually seen with smoking cessation (abstract here).  In 2015, my research group analyzed data from the National Health and Nutrition Examination Surveys to demonstrate that changes in population smoking do not contribute significantly to changes in population overweight and obesity.  (BMC Obesity article available here).

The impact of weight on life expectancy is clear: Those who are underweight or severely obese are at risk of dying prematurely, while mere overweight is associated with a lower mortality rate.



Original author: Brad Rodu
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Vapers: Tell the FDA You’re Not Merely An Anecdote!


A year and a half ago, I blogged about government agencies ignoring federal survey data showing that 2.5 million former smokers were current vapers (here).  When FDA tobacco center director Mitch Zeller dismissed this evidence as mere “anecdotal reports,”  I argued that such data constitutes legitimate population-level evidence.

Aiming to build a fresh dataset on smokers’ success in using vapor as a quitting aid, the Vapor Technology Association (VTA) and Consumer Advocates for Smoke-Free Alternatives (CASAA) just launched a national campaign called “I Am Not An Anecdote” (here).

The groups are asking vapers to submit to the FDA detailed, sworn statements to “encourage Congress and federal regulators to reject any proposal that would ban OR limit flavored e-liquid products.” The groups note that “FDA Commissioner Scott Gottlieb has said that your ‘personal stories are important to me.’  But, he also refers to your stories of quitting cigarettes with vapor products as ‘anecdotes.’”

While individual cases are, in scientific terminology, anecdotal, their cumulative value is considerable.  Vapor is replacing combustion at dramatic rates worldwide.  My research team used 2013 FDA-funded survey data to produce a peer-reviewed report on U.S. e-cigarette use (hereand here).  Our analysis showed that e-cigarettes are the most popular quit-smoking aid among American smokers and that they are the only aid more likely to make them former smokers (i.e., successful quitters) than are cold-turkey attempts (here).

FDA should give weight to published studies, even when they do not conform to visions of a tobacco-free society.  The agency should also recognize the scientific value of mass declarations of smoking cessation accomplished through vaping substitution.




Original author: Brad Rodu
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Five Flavor Review

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