(Press-News.org) Smokeless tobacco and, more recently, e-cigarettes have been promoted as a harm reduction strategy for smokers who are "unable or unwilling to quit." The strategy, embraced by both industry and some public health advocates, is based on the assumption that as smoking declines overall, only those who cannot quit will remain. A new study by researchers at UC San Francisco has found just the opposite.
The researchers analyzed survey data spanning 18 years in the United States and six years in the European Union. They found that, contrary to the prevailing assumptions, as the fraction of the population that smoked declined, the remaining smokers actually smoked less and were more likely to quit than to stick with it. The authors said their findings challenge the need to promote new forms of nicotine delivery, such as e-cigarettes, since the smoking population continues to quit smoking as a result of proven policies and interventions.
The paper, titled, "The smoking population in the USA and the EU is softening not hardening," appears online in the June 24, 2015 issue of the journal Tobacco Control.
The concept of harm reduction, first proposed in the 1970s, was based on the theory that as smoking prevalence declines, the remaining "hard core" smokers will be less likely or able to quit smoking, a process called hardening. The study found that the population is actually softening.
"The fact that the smoking population is softening has important implications for public health policy," said senior author Stanton A. Glantz, PhD, the American Legacy Foundation Distinguished Professor of Tobacco Control at UCSF and director of the Center for Tobacco Control Research and Education. "These results suggest that current tobacco control policies have been leading to softening of the smoking population without the need to promote new recreational nicotine products like e-cigarettes."
The paper reported that for each 1 percent drop in the fraction of the population that smoked, the number of smokers who tried to quit increased by 0.6 percent in the United States and remained stable in Europe. They also showed that the percentage of U.S. smokers who quit increased by 1.13 percent, while daily cigarette consumption among remaining smokers dropped by 0.32 cigarettes in the United States and 0.22 cigarettes in Europe. Overall U.S. cigarette consumption levels dropped over time, while those associations remained stable in Europe.
The findings are significant, said Margarete C. Kulik, PhD, postdoctoral fellow at the Center and first author of the paper, because e-cigarettes are not harmless. A recent review of the science on e-cigarettes by UCSF researchers reported that e-cigarette emissions contain both nicotine and other toxins, such as formaldehyde, and are associated with significantly lower odds of quitting cigarettes and with high levels of dual use - smoking both e-cigarettes and regular cigarettes - among adults and youth.
The takeaway, Kulik said, is that the current policies have been working, including strong anti-tobacco media, smokefree laws and increased tobacco taxes. As a result, smoking prevalence has declined and the smoking population has become more likely to quit smoking altogether.
"We show that there is no real need to distribute e-cigarettes as part of a tobacco policy package because the smoking population is softening," she said. "Tobacco control policies should continue to move the population down these softening curves rather than changing policies to promote new forms of nicotine delivery, especially ones like e-cigarettes that are very appealing to children."
INFORMATION:
This work was supported by the National Cancer Institute (grants CA-113710 and CA-060121).
About UCSF: UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children's Hospital San Francisco. Please visit http://www.ucsf.edu.
An investigation published by The BMJ today reveals how the controversial concept of "harm reduction", embraced enthusiastically by the tobacco industry, has sharply divided the public health community.
On one side of the increasingly bitter dispute are those who believe it is time to work with the industry in support of products such as e-cigarettes.
Those in the other camp, however, not only contest the claimed public health benefits of the new products but also fear harm reduction is a cynical and superficial smokescreen for an industry that has every intention of ...
Women who have experienced a stillbirth have up to a fourfold increased risk of stillbirth in a second pregnancy compared to those who had an initial live birth, finds a new meta-analysis published in The BMJ this week.
Stillbirth rates have declined across most of Europe, but the UK still has a major public health problem. Ranked 33rd out of 35 for stillbirth rates among European countries, the UK recorded 3,286 stillborn babies in 2013.
"Stillbirth is one of the most common adverse obstetric outcomes and a traumatic experience for parents," explain Sohinee Bhattacharya ...
Countries most affected by HIV must focus on stopping new HIV infections and expanding access to antiretroviral treatment or risk the epidemic rebounding, urges a major new report from the UNAIDS and Lancet Commission.
"We must face hard truths--if the current rate of new HIV infections continues, merely sustaining the major efforts we already have in place will not be enough to stop deaths from AIDS increasing within five years in many countries," said Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, Co-Chair of the Commission, and ...
Congress needs to immediately lift the ban on federal funding for needle exchange programs to counter the threat of HIV outbreaks among injection drug users like the one that has seen an alarming number of new cases erupt in a single rural Indiana county.
So say Johns Hopkins Bloomberg School of Public Health Professor Chris Beyrer, MD, MPH, and Steffanie A. Strathdee, PhD, director of the Institute of Global Health at the University of California-San Diego, in a commentary published online June 24 in The New England Journal of Medicine.
"There are going to be more ...
DALLAS, June 24, 2015 -- Nearly half of Hispanic adults were unaware they have high cholesterol, and less than a third receive any kind of cholesterol treatment, in a new study in Journal of the American Heart Association.
Hispanics are one of the fastest growing ethnic groups in America, with 52 million among the U.S. population, yet their awareness and management of high cholesterol lags behind other ethnic groups. Educating Hispanics/Latinos about the importance of maintaining healthy cholesterol levels could have a significant public health impact on reducing the ...
COLUMBIA, Mo. - When older adults transfer between nursing homes and hospitals, inefficient and unclear communication between the organizations can hinder patient care. Now, a team of MU researchers is working to improve patients' health outcomes by increasing efficient, secure communication between nursing homes and hospitals using an electronic communication system called a health information exchange (HIE).
"The exchange of accurate, complete and timely information between hospitals and nursing homes can be complicated when older adults transfer from one place to another," ...
Putnam Valley, N.Y. (June 24, 2015) - Cell transplantation researchers have successfully used bone marrow-derived mesenchymal stromal cells (MSCs) to treat a variety of diseases and conditions. Now, using injections of MSCs, a research team in Brazil has successfully treated laboratory rats modeled with severe burns. They found that the MSCs accelerated healing, enhanced local blood supply, affected the immune system in a positive way, secreted beneficial growth factors with anti-inflammatory properties, and ultimately provided higher survival rates than in control animals ...
Urinary tract and sexually transmitted infections in women are misdiagnosed by emergency departments nearly half the time, according to a paper in the Journal of Clinical Microbiology, a publication of the American Society for Microbiology. These misdiagnoses result in overuse of antibiotics, and increased antibiotic resistance, according to Michelle Hecker, MD, an assistant professor in the Department of Medicine, Division of Infectious Diseases, MetroHealth Medical Center, Case Western Reserve University, Cleveland, and her collaborators.
"Less than half the women ...
Astronomers using NASA's Hubble Space Telescope have discovered an immense cloud of hydrogen dubbed "The Behemoth" bleeding from a planet orbiting a nearby star. The enormous, comet-like feature is about 50 times the size of the parent star. The hydrogen is evaporating from a warm, Neptune-sized planet, due to extreme radiation from the star.
This phenomenon has never been seen around an exoplanet so small. It may offer clues to how other planets with hydrogen-enveloped atmospheres could have their outer layers evaporated by their parent star, leaving behind solid, rocky ...
Cystic fibrosis is more deadly for Hispanic than non-Hispanic patients, a disparity that is not explained by differences in their access to health care, according to a new study from the Stanford University School of Medicine.
The study, published online June 18 in Chest, tracked more than 1,700 California residents with cystic fibrosis. Between 1991 and 2010, Hispanic CF patients were almost three times as likely to die as non-Hispanic CF patients, the study found. The gap in survival existed in spite of the fact that both groups visited CF specialty clinics equally ...
