Wednesday, December 7, 2016

Smokers: It’s Never Too Late to Quit or Switch to Smoke-Free

A new study from researchers at the National Cancer Institute and the National Institute on Aging finds that even smokers in their 60s who quit can reduce their chances of dying early. 

In 1995, 160,000 people age 50-71 years were enrolled in the study; data on their smoking and quitting was collected in 2004-2005.  Researchers documented causes of death and calculated rates through 2011 among never, current and former smokers, with adjustment for other risk factors.  The study appears in the American Journal of Preventive Medicine (abstract here).

Current smokers were three times as likely to die during the study as never smokers.  Compared with current smokers, former smokers had significantly lower death rates; the magnitude of the reduction correlated with the age when they quit.  For example, smokers who quit in their 30s had a death rate that was 57% lower, while those who quit in their 50s had a 36% lower rate.  Even smokers who quit in their 60s had a 23% lower rate.

This study should give hope to smokers of all ages, but this is not new information.  In 1996, Dr. Philip Cole and I published similar research in the journal Epidemiology (here).  We estimated how long never and current smokers of various ages would live on average.  In addition, we estimated remaining years for quitters and switchers.  Here are our results: 

Average Years of Life Remaining According to Tobacco Use and Age

Sex and Age (years)Never SmokerContinuing SmokerQuitterSwitcher




The good news: No matter what age, smokers can improve their life expectancy if they quit or switch.  It’s never too late to move to a smoke-free substitute.

Friday, December 2, 2016

Exploding E-Cigarette? Maybe Not.

“A worker at a wine store in Grand Central Terminal suffered burns to his hand and leg after an e-cigarette caught fire in his pocket,” according to a November 23rd ABC news story (here). 

This incident requires context.  Christopher E. Lalonde, a psychology professor at the University of Victoria in Canada with expertise on e-cigarette hardware, made the following comments:

“The device appears to be a Reuleaux RS200 model... It has various safety features designed to protect against such incidents: reverse battery protection, overheating/auto cut-off, battery venting, etc…Not foolproof by any means, but ‘e-cigs’ and ‘cellphones’ don’t explode, batteries do.

“The Reuleaux requires three 18650 batteries to operate. There appear to be six batteries in the photo — along with an assortment of metal coins.

“The three seemingly intact brown coloured batteries (far left, far right, and one remaining in the device) are likely LG 18650s that are recommended for use with this model.

“…I suspect the three silver coloured charred batteries are likely the cause of the explosion. If they were carried along with loose coins in the victim’s pocket, then the “e-cig” didn’t explode — the loose batteries did.” (my emphasis)

Professor Lalonde, while noting that he has “every sympathy for the unfortunate victim of this incident,” provided valuable insight by suggesting that, based on the photographic evidence, batteries interacting with pocket change was the likely cause of this explosion. 

Lithium ion batteries are essential for a wide range of electronic devices.  Consumers should use, charge and store them with care. 

Wednesday, November 23, 2016

Motorcycles Aren't Cars and Cigarettes Aren't Smoke-Free Tobacco

What if the federal government told you that cars are as dangerous as motorcycles?  Well, you would be living – and dying – in TobaccoWorld.  Read my commentary that appeared in the Washington Examiner (here) and is reprinted below.

Motorcycles are more dangerous than cars. We know this because a government agency, the National Highway Traffic Safety Administration, routinely provides data that confirms it.

For example, the NHSTA reports there were 0.85 auto-related deaths for every 100 million miles Americans drove in 2014. By contrast, the death rate for motorcycles was 22.96 for every 100 million miles, making motorcycles 27 times deadlier than cars.

What if the government ignored this difference in risk and assumed the motorcycle death rate applied to all vehicles? In other words, what if all vehicle manufacturers had to be governed by motorcycle regulations and what if insurance premiums for car owners were pegged at the much higher rates for motorcycles?

The effect of such irrationality would be intolerable, with cars priced out of reach, companies put out of business and consumers left without choice. Policymakers would never inflict such pain on the American driving public – at least, not on purpose.

But that's just the sort of irrationality being imposed on the nation’s consumers of smoke-free tobacco products, with tragic consequences. Federal agencies routinely conflate the risks of using smoke-free tobacco products with the risks of smoking, despite decades of scientific studies demonstrating that smoke-free products are vastly safer than cigarettes.

Smokeless tobacco products are required by the Food and Drug Administration to carry demonstrably inaccurate and misleading safety warnings. Companies that attempt to challenge those messages are held to the unnecessary and financially crippling standard of proving that their products would have virtually no health impact on the population.

Even when a company did provide irrefutable proof to change the warning labels in 2011, the FDA took four years to deny its citizen’s petition. Another company’s formal application from 2014 remains in FDA limbo.

The FDA ignores extensive evidence from federal surveys of the role e-cigarettes are playing in helping smokers to quit—including some 2.5 million successes—while the Centers for Disease Control and Prevention withholds evidence that smokeless tobacco is safer

The Affordable Care Act permits health insurers to charge higher premiums for any recreational nicotine use, not just smoking.  Most life insurance companies also fail to recognize established risk differences, as they charge higher premiums for users of all nicotine products, even medicines. 

No one confuses motorcycles with cars, just as no one, other than government officials, confuses cigarettes with e-cigarettes or cans of moist snuff. The risk differential between combustible and smoke-free tobacco products is proven and profound. It’s time to tell the public the truth, and to regulate accordingly.