Mixed signals on smoking and COVID-19

I haven’t done an update for a while. I’ve been pretty busy, then like most people, my life has been upended by the effects of the COVID-19 virus and blogging took a backseat.

Then, in late April, our blog was hacked. By someone in China using our blog to sell guitars. Man, this blog has been through the ringer. I shut the first one down over doxxing, the second one got banned by WordPress, the third one I had to kill because the hosting company was terrible. And now this one got hacked.

So, we got the blog fixed and I decided an update was long overdue,  especially with lung health being front and centre in world news the past few weeks. So here goes. Good to be back!:

Mixed signals on smoking and COVID-19

I was fairly shocked to see a story out of France that according to a study, somehow smoking and or nicotine was shown to protect people against the COVID-19 virus. That just doesn’t make any sense. One of the highest-risk groups out there for COVID-19 are people with COPD.

From the New York Daily Post:

A French study suggests that smokers could be less at risk of catching the coronavirus — and researchers now want to test nicotine patches on patients and health care workers.

Despite their findings, the researchers at a major Paris hospital insisted they are not encouraging folks to take up smoking, which carries severe health risks — including if a smoker does become infected with COVID-19.

Instead, they are probing whether the nicotine in cigarettes specifically plays a part in stopping smokers from catching the illness — and therefore could help protect patients and frontline health workers.

Accounting for age and sex, the researchers found that the number of smokers among their patients was much lower than that in the general French population.

“Our cross-sectional study strongly suggests that those who smoke every day are much less likely to develop a symptomatic or severe infection with Sars-CoV-2 compared with the general population,” the researchers wrote.

That’s hard for me to believe, and sure enough other scientists are expressing their doubts about this study. There’s definitely contradictory evidence.

That study caused a huge rush in France and elsewhere on nicotine products such as gum and patches.

Other studies suggest smokers, even those without COPD or lung cancer, fare worse against COVID-19

From a USA Today article:

In an overview by the National Center for Biotechnology Information of five different studies suggesting that nicotine may aid in severe COVID-19 cases, it was found that “smoking is most likely associated with the negative progression and adverse outcomes of COVID-19.”

On April 21, Bloomberg News reported the U.S. Food and Drug Administration revised its stance on COVID-19 and nicotine, saying nicotine could also increase the chances of catching the coronavirus. It was reported earlier in the month that smokers could have worse outcomes from the virus.

Here is a UC San Francisco study suggesting that smoking nearly doubles the rate of COVID-19 progression:

Smoking significantly worsens COVID-19, according to a new analysis by UC San Francisco of the association between smoking and progression of the infectious disease.

In a meta-analysis of studies that included 11,590 COVID patients, researchers found that among people with the virus, the risk of disease progression in those who currently smoke or previously smoked was nearly double that of non-smokers. They also found that when the disease worsens, current or former smokers had more acute or critical conditions or death. Overall, smoking was associated with almost a doubling of the risk of disease progressing.

That is almost completely contradictory from the French study.

Yet another study shows a link between serious complications from COVID-19 and smoking AND vaping.

From NBC News:

The research is new, but evidence suggests smoking may dramatically worsen COVID-19.

Now, almost two months later, researchers are still only beginning to investigate the link between vaping and serious complications from COVID-19. According to Dr. Nora Volkow, head of the National Institute on Drug Abuse (NIDA), there appears to be an association, and increasing evidence, of the dangers. Volkow strongly advises people who are vaping to stop. Back in March, the American Lung Association’s chief medical officer, Dr. Albert Rizzo, and the American Nonsmokers’ Rights Foundation also issued warnings.

Researchers are still only beginning to investigate the link between vaping and serious complications from COVID-19.

It’s not just a domestic suggestion. The World Health Organization also recently released information from China, where the coronavirus originated, showing that people who have cardiovascular and respiratory conditions caused by smoking or water pipes are at higher risk of developing severe COVID-19 symptoms. In April, NIDA announced that SARS-Cov-2 — the coronavirus that causes COVID-19 —could be an especially serious threat to those who smoke

So, that French study while interesting appears at the moment to probably be some kind of outlier and that at the very least, the jury is definitely out on the link between smoking and COVID-19 complications.

 

 

 

 

 

Washington, Massachusetts ban flavoured vapes

While Trump and the federal government dithers, the staet of Washington has banned flavoured vapes and Massachusetts may not be far behind.

Washington made the decision via executive order in October, but it’s not necessarily permanent. The ban is just for 120 days, but Gov. Jay Inslee has requested a permanent ban via state legislation.

From a CNN.com article:

Matthew Myers, president of the advocacy group Campaign for Tobacco-Free Kids, applauded Inslee and supported the call for a ban on the sale of flavored e-cigarettes in Washington state.

Massachusetts to temporarily ban the sale of e-cigarettes and vaping products

“The time is now to end the youth e-cigarette epidemic, and Gov. Inslee’s call for prohibiting flavored e-cigarettes is exactly what we need,” Myers said in a written statement.

“The evidence is clear that flavored e-cigarettes have fueled this epidemic — 97% of youth e-cigarette users report using a flavored product in the past month and 70% cite flavors as the reason for their use. The recent spate of serious lung illnesses associated with e-cigarette use has added to the urgency of acting now to protect our kids and, indeed, the health of all Americans,” he said in the statement. “We look forward to working with Gov. Inslee and state lawmakers to pass this legislation and end the youth e-cigarette epidemic.”

Massachusetts may be next.

The state Senate of Massachusetts approved a ban on all flavoured e-cig products and a 75 percent excise tax on e-cigs. The state house earlier approved a similar bill.

The bill will be sent to a joint committee before being sent to Gov. Charlie Baker, a Republican. Baker has not stated if he will approve it, but he did impose a temporary ban on e-cig sales after the rash of illnesses broke out earlier this year.

The state of Michigan and the city of San Francisco have already banned the sale of e-cig flavours. San Francisco’s ban is a ban on all e-cig sales, period.

The AMA calls for total ban on vaping

The American Medical Association this week called for not just a ban on vaping flavourings, but a total ban on vaping … period.

From a CBS News article:

The AMA cited the lack of evidence about the short- and long-term health impact of e-cigarettes and vaping products in making the call for a total ban. The doctors’ group said a separate health issue also prompted its action — the recent U.S. outbreak of lung illnesses linked to vaping. Most of those sickened said they vaped THC, the high-inducing ingredient in marijuana, not nicotine. Officials believe a thickening agent used in black market THC vaping products may be a culprit.

About 2,100 people have gotten sick; 42 have died.

“It’s simple, we must keep nicotine products out of the hands of young people.” Dr. Patrice Harris, AMA’s president, said in a statement.

The AMA has previously sought bans on e-cigarette flavors and ads. At the same time, some states, municipalities and corporations are seeking to limit the products, with Massachusetts lawmakers set to vote on Wednesday on a bill that would ban flavored tobacco. That measure is aimed at reducing vaping among teens, with researchers finding that 5 million children and teens are now using the products.

Yeah, I’m thinking the AMA position might be a bit overly strong. I’m all for banning or at least regulating ecig advertising and banning the sugary flavours. But a total ban would leave millions of vapors, many of whom legitimately use vaping to get off cigarettes, with no other option but to run back to cigarettes for their nicotine fix.

No ban on vaping flavours — quelle shock!

I totally did not see this coming: Trump backs off proposed ban on e-cig flavouring

I kid — I totally DID see it coming.

All along Trump has been acting like he’s somehow going to crack down on tobacco and the vaping industry and all along, he has been backing off. His original surgeon general, Scott Gottlieb, was actually surprisingly harsh toward both the tobacco and the vaping industry — and of course, he mysteriously resigned from his position to … “spend more time with my family.” (Seriously, that the was the reason he gave.).

So, I’ve been somewhat skeptical all along about all the noise the Trump Administration has been making about cracking down on vaping flavourings in light of the epidemic of teen vaping use and the 2,000 or so people sickened by vaping fluids.

SURE ENOUGH .. my instincts proved to be right. Trump never intended to go through with it.

As soon as the administration got pressure from lobbyists (ie, the tobacco industry, which controls about 90 percent of the vaping industry), they totally caved. There will be NO ban on vaping flavourings.

Honestly, I think the proposal was a bit of an overreaction to the 35 or so deaths from vaping. Not because those deaths aren’t a big deal. They are. But, because they were pretty much exclusively caused by vaping bootleg THC off the street.

What ISN’T an overreaction is the explosive growth in teen vaping — and absolutely I believe having bubble gum, Rice Krispie Treat and Mountain Dew flavourings for nicotine vaping is a factor.

According to CNN, the administration backed down because of fears it “would upset the base.”

From CNN:

A Trump campaign adviser told CNN’s Jim Acosta that Trump’s political aides, including campaign manager Brad Parscale, have warned him that such a ban may not be helpful with his base and that he should reconsider.

Trump was persuaded by advisers to back off the proposal during a November 4 flight to a political rally in Kentucky, the Times said. Following the conversation with advisers, the newspaper reported that Trump canceled the administration’s planned announcement that was scheduled for the next day.

The planned news conference, which would have included Health and Human Services Secretary Alex Azar, was canceled and another meeting was proposed, according to the report.

Personally, I don’t buy that it was “all about the base.” There might be something to that, but honestly, I just don’t see this as a frontline issue with most people, not with impeachment hearings going on and children being thrown in cages at the border. I have a feeling this is really about lobbying.

This American Prospect investigative piece shows how much the tobacco industry has been fighting a ban on vaping flavours all the way back to the Obama Administration.

From the American Prospect:

Juul, already under federal civil and criminal investigation over marketing to children, saw its CEO step down. But the replacement, K.C. Crosthwaite, was formerly a top Altria executive. A second, former Altria regulatory affairs chief Joe Murillo, is also headed to Juul. The alleged antidote to Big Tobacco has transformed into an adjunct of Big Tobacco overnight. And Juul had already been running the Big Tobacco playbook, hiring a bipartisan all-star team of lobbyists, from former Massachusetts Attorney General Martha Coakley to former Trump administration adviser Johnny DeStefano.

This week, the Trump Administration is holding a meeting with industry representatives and public health officials. Guess which side gets listened to?

Double lung transplant due to vaping; possible cause found to vaping illnesses

Also this week, a story on a teenager who required a double lung transplant due to his lungs being damaged by vaping.

It’s a harrowing story on how vaping completely destroyed a 17-year-old’s lungs. It’s really sad.

From an NBC News article:

“Doctors at Henry Ford Health System in Detroit, where the teen was treated, said they had never seen such scarring on someone’s lungs from vaping.”

“‘This is an evil that I haven’t faced before,” Dr. Hassan Nemeh, a thoracic specialist at Henry Ford Health System, said during a news conference.”

Wow, that’s some pretty hairy quotes. It really brings it home just how destructive the vaping illnesses have been. More than 40 people have died now and more than 2,000 have been sickened. Nemeh urges kids to stop vaping all products, not just THC products.

According to the story, vaping of both nicotine and THC products has caused the thousands of deaths around the country from vaping (and a few dozen deaths). I do believe it is mostly THC products being sold on the street.

Here’s an interesting aspect to the story. Scientists think they might have tracked down the cause of the illnesses — at least one of them. It’s Vitamin E acetate, which is being used as a diluting agent in THC vapes. Vitamin E acetate, a synthetic form of Vitamin E, has been found in half of the 419 THC vaping fluids tested by the Food and Drug Administration.

Here is a statement from the Centers for Disease Control:

CDC recommends that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers. Until the relationship of vitamin E acetate and lung health is better understood, vitamin E acetate should not be added to e-cigarette, or vaping, products.

One of the original Marlboro Man dies at 90

An interesting story about one of the very first “Marlboro Man,” who actually never smoked a single cigarette. He died last week at the age of 90. It’s a neat story.

Bob Norris was approached by Philip Morris ad executives (I imagine Don Draper out of “Mad Men” in his grey suit out in the high plains…) in the 1950s while he was talking to John Wayne outside of a ranch in Colorado. It’s debatable whether he was the first-ever Marlboro Men, but he had a nice run of 12 years of being in magazine ads and billboards in the 1950s.

Here’s a neat story of why Morris quit doing the ad campaign, even though it made him a lot of money. One of his kids got old enough to ask him about “If you don’t approve of us smoking, why are you in cigarette ads.” Norris claimed he quit modeling as the Marlboro Man the day after that.

Bob Norris might have had the longest life of the several real-life cowboys who played Marlboro Men over the decades. Six of them — SIX — died of tobacco-related illnesses, including one who died at the age of 52 from lung cancer. Three others died of lung cancer, one at the age of 72 and the other at 73, and a third died of COPD. So many Marlboro Men died of smoking that Marlboros became known as “Cowboy Killers.”

So Norris outlived them all. Unfortunately, for 12 years, he didn’t really think about the morality of what he was doing (back in his day, few people gave much thought to the morality of cigarettes, frankly) but he came around. And that’s what’s important.

San Francisco refuses to overturn e-cig ban

Juul, which ironically enough is actually based in San Francisco, helped finance a ballot measure to overturn the city of San Francisco’s ban on selling e-cigarette products in the city.

Well Juul … you get NOTHING. The Juul-backed measure failed by 78 percent. Let me reiterate … 78 fucking percent. San Franciscans are sick your shit … and your lies, vaping industry. Go sell your products in San Jose … for a little while before the FDA inevitably all but destroys the vaping industry.

Keep in mind, this is not a ban on vaping. It is simply a ban on selling vape products in the city.

From a San Francisco Chronicle article:

City Attorney Dennis Herrera, who actively supported the No on Prop. C campaign, said in a statement Tuesday night, “Juul is Big Tobacco, and it’s using a classic ploy from the Big Tobacco playbook to try and hook another generation of kids on nicotine. Voters saw right through Juul’s deception.

“San Francisco already has the toughest e-cigarette regulations in the nation. By law, e-cigarettes must undergo FDA review to ensure they are safe for public health. Complete FDA review and you can sell your product here. If you don’t, you can’t. It’s that simple,” Herrera said.

“Juul spent millions trying to mislead San Franciscans and rewrite the rules to benefit itself before realizing that was a fool’s errand. It could have put that time and effort into completing the required FDA review,” he said. “Perhaps FDA review is a test that Juul is afraid it can’t pass.”

Federal ban on e-cig flavourings happening any day now?

Hey, it’s an update. Just haven’t had time lately.

This report from USA Today suggests that a federal ban on flavoured e-cig products is going to happen “very soon.”

This has been building up for months, partly because of the genuine alarm over the rapid increase in teen use of vaping products and partly over the hysteria over vaping illnesses and deaths the past few weeks (though most of those illnesses appear to have been from marijuana vaping products, not nicotine vaping products.).

In anticipation for the upcoming ban, Juul, one of the biggest  has already stopped selling menthol-flavoured vaping pods.

When it happens, I will have ZERO sympathy for the industry. For years, they got away with marketing their products to teenagers, for years they got away with enticing kids to vape addictive nicotine  through candy flavourings like bubble gum,

It’s a shame for people who have legitimately quit smoking via e-cigs, lord knows I’ve talked to enough of them over the years to accept that their dedication to the power of e-cigs is sincere, but this is what happens when you have an utterly unregulated industry operating with zero oversight … golly, the bottom line becomes vastly more important  to them than the social good. Call me an SJW. Whatever.

I’m guessing what this means is that e-cigs will have to be unflavoured from now on? Not sure on that.

It’s also possible that these flavourings will simply be banned from minimarkets and convenience stores and that only vape shops will be allowed to sell them … which was an idea (and a GOOD idea) originally proposed a year or two ago that the FDA dropped. Vape shops are more strictly regulated than convenience stores and are more stringent about keeping minors from coming in the door.

From the USA Today article:

A sign of the imminent ban announcement came Monday, when the Office of Management and Budget said it concluded its review of the rule and cancelled upcoming meetings with industry and consumer interests. (White House spokeswoman Kellyanne) Conway also said an announcement was coming soon. (Yes, that Kellyanne Conway).

On Tuesday, the FDA and Centers for Disease Control and Prevention published findings highlighted in September when Trump and Health and Human Services Secretary Alex Azar announced the planned ban. E-cigarette use among high school students more than doubled from 2017 to 2019 to 27.5%. About 5.3 million middle and high school students used e-cigarettes this year, up from 3.6 million in 2018.

Another study, also published in the Journal of the American Medical Association, found after Juul stopped selling mango and other flavors in November, high school students simply switched to mint.

Flavoured vaping fluid to be banned

An 18-year-old teen sickened by e-cigs

OK, by now, you’ve heard the huge news  … shockingly yesterday, the Trump Administration has proposed banning flavoured e-cigarette fluids in light of e-cig illnesses that have struck hundreds of people and killed 6 people so far.

Weirdly enough, I wasn’t completely surprised by it — the tide has been turning against e-cigarettes for months now — but I was shocked at how quickly the decision came and with how little warning there was that something was afoot.

I can’t really add a lot to the reams of articles I’ve been reading the past couple of days about this other than to add my thoughts about this move.

First of all, I would not be remotely shocked at all if Trump and his administration completely reverses their decision. It wouldn’t be the first time. This is a virulently pro-business and anti-regulation administration … I mean they’ve all but completely gutted EPA rules and regulations over the past three years.

And this is a very anti-business move. The e-cig industry is a multi-billion dollar industry and Trump has effectively gutted it overnight. AND keep in mind, the e-cig industry IS the tobacco industry. Roughly 90 percent of the e-cig market is controlled by Big Tobacco (RJ Reynolds, Altria and British American Tobacco).

I imagine Big Tobacco either won’t be happy with this move or they’re willing to sacrifice the e-cig industry in the name of public relations, thinking all those nicotine-addicted e-cig users will simply go back to cigarettes.

Secondly, I have mixed feelings about this. From talking to myriad e-cig users, I respect that they have genuinely helped millions of people quit smoking. Yeah, people are getting sick on e-cig fluids, but this appears to be stuff people are buying on the street and most of the time, it appears to be marijuana vaping. This isn’t Juul or Blu behind this.

So, is this just going to drive adult vapers back to cigarettes? Will there just be unflavoured vaping fluids now? Is the flavouring part of the appeal of vaping for grown-ups? We’ll see.

Yes, teen vaping is a HUGE issue, I’ve been railing about it for two or three years now. The flavourings are part of the issue. It pisses me off to no end to see bubble gum flavoured e-cig products with nicotine. Or cookie dough flavour. Or Rice Krispie Treat flavour. My reaction when I see some of the flavours out there is: “You have got to be shitting me.” The industry is CLEARLY trying to get kids addicted.

So, in that sense, I do agree something has to be done. It’s well past time. It’s too bad more can’t be done to keep these products strictly in the hands of adults.

Thirdly, I’ve seen a number of people make a very valid point about “Six people die from vaping, Trump takes action. Thousands killed by guns … nothing.”

Yeah, fair enough, I can’t really argue with it, though I would say it’s not necessarily an “either or” situation. You can care about both vaping and guns.

Again, I’m pretty cynical that Trump is actually going to follow through with this. I just get the sense that Big Tobacco lobbyists are working round the clock to get this either reversed or watered down.

 

 

 

Michigan bans e-cigarette flavouring

Michigan becomes the first state in the country to ban the sales of e-cigarette flavouring, joining the city of San Francisco, as it becomes more and more blatant that flavoured e-cig juices are intended to entice teenagers.

From an Associated Press article:

The federal government and states ban the sale of vaping products to minors, yet government survey figures show that last year, one in five U.S. high school students reported vaping in the previous month. Top government health officials, including the surgeon general, have flagged the trend as an epidemic.

“This is a health crisis that we’re confronting, and it would never be permitted if it was cigarettes. We’re letting these companies target our kids, appeal to our kids and deceive our children,” Whitmer told reporters. Michigan’s chief medical executive determined that youth vaping constitutes a public health emergency.

Man, this is insane on this e-cig graphic I pulled up online of some e-cigarette flavours — pancake mix, strudel, watermelon bubble gum, blueberry, and Rice Krispie treats.

Wait … RICE KRISPIE TREATS?

Rice Krispie Treats. And you’re telling me these AREN’T being used to entice kids? Seriously? When I see shit like this, I have ZERO sympathy for the e-cig industry and the regulatory morass that is coming for them. They literally BEGGED for it. Jesus. Are people using e-cigs to quit smoking REALLY wanting pancake mix and Rick Krispie Treat flavoured e-cigs?

From the AP story:

Nearly 80% of underage teenagers who use e-cigarettes and other tobacco products cited flavors when asked why they took up the habit, according to government research.

Think about that. 80 percent. See if any other jurisdictions start banning e-cigarette flavouring.