Tobacco Harm Reduction and Nicotine Containing Products: Research Priorities and Policy Directions

Developments in tobacco harm reduction (HR) and the proliferation of nicotine containing products (NCPs) have important implications for tobaco control (TC). This report sets out a research agenda which will help map and examine these implications

The marketing of e-cigarettes: a quick snapshot

First paragraph: The electronic cigarette (e-cigarette) was launched as a new consumer product in the UK eight years ago.ii Sales now exceed half a million per year and analysts predict the e-cigarette industry, which is worth £150 million in the UK,iii will continue to grow as usage among smokers has more than doubled in two years.iv At present, they are not classed as tobacco products or medicines in the UK and are therefore only regulated under Trading Standards legislation. The situation may change if the health regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), enforces tighter regulations - a decision on whether e-cigarettes require marketing authorisation to prove safety and efficacy is imminent

Britain's efforts to reduce smoking are becoming a cash cow for big tobacco

First paragraph: It all began so well. A decade ago a heartfelt concern about the addictiveness of nicotine, and the enormous difficulties this presented for would-be quitters, led to an unprecedented investment in intensive smoking cessation services. Beyond Smoking Kills proudly proclaimed year-on-year increases in funding for stop-smoking services and the establishment of centres throughout the country. Access this article on The Conversation website: https://theconversation.com/britains-efforts-to-reduce-smoking-are-becoming-a-cash-cow-for-big-tobacco-2533

Promotion of electronic cigarettes: tobacco marketing reinvented?

Electronic cigarettes are not subject to the same marketing controls as tobacco products. Marisa de Andrade, Gerard Hastings, and Kathryn Angus argue that their advertising is likely to appeal to young people and undermine tobacco control policy

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead.

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Hostage to fortune: an empirical study of the tobacco industry’s business strategies since the advent of e-cigarettes

The tobacco market has been transformed by the arrival of e-cigarettes and array of alternative nicotine delivery systems (ANDS). Public health has struggled to cope with these changes and clear divisions are apparent, but less is known about the tobacco industry (TI) response. This first empirical study to examine TI and independent ANDS companies’ business strategies fills this gap. Primary data were collected through 28 elite interviews with senior/influential TI and independent stakeholders, triangulated with a documentary analysis of company reports, investor analyses, market research, and consultation responses (1022 documents). A deliberately emic analysis shows that tobacco multinationals were initially disconcerted by ANDS, but logic provided by the fiduciary imperative is enabling them to turn a potential threat into profitable opportunities. Interviewees argue market changes played to their strengths: customer links, expertise in nicotine, and enormous financial resources. This enabled portfolio diversification in which combustible and ANDS coexist; providing potential to develop robust scientific and regulatory positions and hope of retrieving corporate reputations. The principal threat for major tobacco players comes from the independent sector, which is prepared and able to satisfy bespoke consumer needs. Multinationals by contrast need to turn ANDS into a genuinely mass-market product appealing to its global customers. They are making progress. Given the continued buoyancy of the combustibles market, they have extensive resources to continue their efforts. Disruptive innovations are not unique to tobacco control. Equivalent technological solutions – with concomitant business opportunities − are emerging in obesity and alcohol fields with implications for public health

The Marketing of Electronic Cigarettes in the UK

First paragraph: Tobacco harm reduction has long been a public private partnership (PPP), with all the potential conflicts of interest between the two sectors that such arrangements bring. Until recently, however, this was a relatively simple PPP, between tobacco control and one private partner: the pharmaceutical industry. Now a combination of technical innovation and an energised debate about harm reduction has opened the territory to two new private sector operators: electronic cigarette (e-cigarette) companies and tobacco companies, which has stimulated a dramatic increase in commercial activity. This study was commissioned to examine these developments, and map out both current activity and likely future trends. It covered the period from May 2012 to June 2013, and comprised a systematic audit of all forms of e-cigarette marketing, as well as the related public relations and editorial comment in tobacco industry and retail trade press. Traditional and digital / social networking outlets were included. In addition, in-depth interviews were conducted with marketing experts to help make sense of what was a very extensive data set: 991 discrete items (editorial, images, online posts and advertising) were identified

Emotion in the ANDS (alternative nicotine delivery systems) market: Practice-theoretical insight into a volatile market

Purpose The alternative nicotine delivery systems (ANDS) market is complex, with a range of multi-national and multi-sector stakeholders competing for market share but also clashing ideologically as the evidence about the impact and side-effects of ANDS emerges. This empirical study examines the beliefs, goals and emotions at the heart of the practices performed by actors within the organisations behind the controversial commercial explosion of ANDS. Design/methodology/approach The study was designed to explore business strategies from the viewpoints of ANDS business stakeholders. A purposive, snowball sampling strategy was used to recruit ANDS stakeholders and gatekeepers among UK tobacco multinational and independent companies (n = 28). Data were then analysed using a marketas-practices theoretical framework which specifically frames market activities as practices, governed by teleoaffective structures, which seek to establish market procedures and rules, and which contribute to the taste regimes of a consumer practice. Findings Analysis has indicated that the ANDS market is highly contested and volatile, interwoven with competition, emotion and conflicting beliefs. In this context, there are commercial practices routinely undertaken in an attempt to align stakeholders' beliefs, which is seen as a core part of the corporate activities required within the marketplace. A key driver of these alignment activities is the profit end-goal, but this is in tension with beliefs, such as about doing 'right' and the objectivity of 'science'. Beliefs across this emergent market vary and are strongly held, and they lead to emotional positions, tying back to why aligning stakeholders is difficult. Analysis illuminates how the projects, end goals, emotions and beliefs which comprise the teleoaffective structures of various corporate practices in the ANDS market might inform the rules and norms of the market, shaping a taste regime experienced by consumers. Limitations The data and analysis cannot account for the beliefs and emotions of public health bodies, researchers, the media, policymakers and other stakeholders, but seek to illuminate how teleoaffectivity is a key part of market practices. Furthermore, the taste regimes of ANDS consumers cannot be observed in the data due to the focus on ANDS commercial actors. Finally, it is possible that conscious or unconscious biases in the interviewing style may have driven interviewees' responses and influenced data interpretation. Implications Tobacco control is one of the greatest success stories of public health; smoking prevalence has been driven down with a combination of popular empowerment and corporate containment. All this depended on a coherent and accepted evidence base. As this evidence base has fractured during the evolution of the ANDS market, so the stories have proliferated and progress has become less certain. The high emotion in the ANDS market indicates a tougher task for behaviour change activity targeting corporate actors. Contribution This paper speaks to the multiple calls in the behaviour change literature to tackle the intractable problems of the day through upstream measures including the restriction of corporate activity. The value is in the unique dataset and in the ambition of the project to unravel behind-the-scenes activities in the ANDS market. A practice-theoretical framework, although conceptually complex, is deployed to capture the complex intertwining of multiple practices and thus attempt to grasp the full significance of teleoaffectivity in the marketplace

Inferência em ecologia: Comentários e um exemplo

Statistical confidence intervals and hypotheses tests are important components of ecological studies. Inference tools are often used by researchers when they assess scientific questions and statements. At least three procedures could be used in inference. In this paper we evaluated those procedures when analyzing an example of ecology. We show that the Bayesian approach is in advantage because it allows the researchers to easily answer the relevant questions in ecological studies.A estimativa de intervalos de confiança e a realização de testes de hipóteses são componentes da inferência estatística fundamentais em estudos na área de ecologia quantitativa. Os procedimentos de inferência são freqüentemente utilizados por pesquisadores nas avaliações de questões e afirmações de cunho científico. Pelo menos três procedimentos podem ser utilizados para a realização de inferências. Neste trabalho avaliamos estes procedimentos com a análise de um exemplo de ecologia. Concluímos que a abordagem bayesiana é vantajosa, pois propicia que o pesquisador obtenha respostas diretas para as questões relevantes de um estudo de ecologia