E-cigarettes and Harm Reduction: An Evidence Review, the latest in a series of reports it has published since 2007 endorsing e-cigarettes for harm reduction.  In this report, the RCP minimizes the adverse health effects of nicotine (beyond addiction), concluding that “There is little evidence of a long-term harmful physiological effect of nicotine that is not confounded by those of other constituents of tobacco smoke [page 8].” As with the RCP’s conclusions about health risks and the e-cigarettes and stopping smoking, the conclusion is based on a small fraction of the available evidence ..read more

Tobacco industry denormalization — the strategy of educating people about the predatory behavior of the tobacco industry — is used in many high income states and countries. Now, Roengrudee Patanavanich and I have published “Awareness of tobacco industry tactics among tobacco control communities in Thailand and its association with attitudes towards tobacco industry and perceptions of e-cigarettes” that assesses awareness of the tobacco companies’ tactics in the middle income country Thailand and how awareness of industry behavior affects knowledge and attitudes of tobacco control and public he ..read more

Today (April 16, 2024) the FDA released a new web page on The Relative Risks of Tobacco Products that irresponsibly promotes e-cigarettes as a lower risk alternative to cigarettes. This recommendation is based on the 2018 National Academy of Sciences, Engineering and Medicine report on e-cigarettes that concluded that e-cigarettes reduce exposure to some toxic chemicals. The problem is that, in the science of e-cigarettes, 2018 is ancient history. The NASEM report was a reasonable summary of the evidence on the harms of e-cigarettes as of August 2017, when the literature search it is based on ..read more

Jim Repace, who did the first quantitative risk assessment of secondhand smoke and lung cancer way back in 1980 and helped launch the clean indoor air movement, just published “Secondhand smoke infiltration in multiunit housing: Health effects and nicotine levels” in Indoor Environments. This paper is a combination literature review and summary of data he collected between 2006 and 2023 as part of his work as an expert consultant on exposure to secondhand smoking, including in litigation after he retired from the US EPA. This paper is a great resource for people interested in smokefree multiun ..read more

Karin Kasza and colleagues new well-done study, “Divergence in Cigarette Discontinuation Rates by Use of Electronic Nicotine Delivery Systems (ENDS): Longitudinal Findings From the United States PATH Study Waves 1-6,” uses the large national PATH study to see if there were differences in real-world trends of adults stopping smoking before and after fourth generation e-cigarettes (pioneered by Juul) appeared. Fourth generation e-cigarettes add acid to the e-liquid, which generates nicotine salts that are easier to inhale, increasing the effective nicotine dose. Kasza and colleagues hypothesized ..read more

Philip Morris has aggressively promoted its heated tobacco product (HTP) IQOS all over the world as a safer alternative to smoking cigarettes based on the fact that IQOS delivers lower levels of some combustion products than cigarettes. IQOS is the most populat HTP in Japan, and other tobacco companies make similar claims for their HTP. Satomi Odani and colleagues make an important contribution to the actual effects of HTP on actual disease in people in their new paper “Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan.” They meas ..read more

The 1964 Report on Smoking and Health represented a turning point in the history of tobacco in the United States and the world. Now Don Shopland [photo above], who at the time was an eighteen year-old, “newly working at the National Library of Medicine,” who found himself moonlighting for the Surgeon General’s Advisory Committee that prepared the report, photocopying scientific articles for the committee, just published a detailed history of the committee’s deliberations that led the the report. The book, Clearing the Air: The Untold Story of the 1964 Report on Smoking and Health, uses w ..read more

The UCSF Industry Documents Library released another 519,000 new Juul Labs documents, bringing the total number of documents to 1,053,233. This is about one-quarter of the complete collection of more than 4 million documents. Check out the Juul documents here ..read more

Our recently-published meta-analysis of the association between e-cigarette use and disease (now available open access) found that the risks of e-cigarettes were indistinguishable for cardiovascular disease, stroke and metabolic dysfunction, but did find lower risks for respiratory and oral diseases. Specifically, the risk for oral disease in e-cigarette users was about 13% below that of cigarette smokers (OR 0.87, 95% CI 0.76 to 1.00), with similar effects in youth and adults. Priti Charde and colleagues’ new paper Effects of e-cigarette smoking on periodontal health: A scoping review helps e ..read more

NEJM Evidence has graciously made our recent paper, “Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes,” open access so that anyone can read and download it for free. As described in more detail in my blog post on the paper, it uses data from 107 population epidemiology studies of the association between e-cigarette use and disease to conclude that for cardiovascular disease, stroke and metabolic disorder e-cigarette risks are similar to cigarettes and for respiratory and oral disease, while lower risk than cigarettes, the risks are still substantial.  Dual use ..read more