506 e-Letters

  • E-cigarettes: The Indian Perspective

    E-cigarette is a delusive name for what the product actually is; an electronic vaporization device. Basic parts of an e-cigarette include: a tank containing the liquid to be vaporized, some sort of heating element, a battery to power the device, and a mouth piece. The liquid, often referred to as e-liquid, usually contains a base (for production of thick vapor) and flavor. E-liquid may or may not contain nicotine. The heating element converts the e-liquid into aerosol, which is then inhaled by the user. While many models resemble a conventional cigarette, others look nothing alike. Colloquially referred to vaporizers, such models have become more common in the recent years.
    In the western world e cigarettes proposed as a tobacco control strategy for possible nicotine reduction and stressed on policy appraisals of harm and safety on regulation of other ingredients of the products. The related conflicts and controversies of e cigarettes as a contemporary tobacco control are discussed (1).
    E-cigarettes began to appear in the Indian market around 2010. Today, E-cigarettes pose a complex challenge for the tobacco stricken country. According to Global Adult Tobacco Survey (GATS) 2010, 34.6% of the Indian adults were current tobacco users with 14% of adults indulging in current tobacco smoking (5.7% current cigarette smokers, 9.2% current bidi smokers) (2). Global Youth Tobacco Survey (GYTS) 2009 estimated current toba...

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  • Blogging is a good practice for accessibility

    The editors of this journal, Tobacco Control, and specifically the authors of the editorial “Blog fog? Using rapid response to advance science and promote debate” [1] highlight the need - or requirement, depending on the viewpoint - of utilising a specified platform to debate the finer points of an article.

    From an academic standpoint, individuals that have an interest in a specific field of study - such as Tobacco Control - will see, and respond to, such articles in the appropriate manner. However, one of the pitfalls prevalent in any rapid response platform, and this isn’t limited to the journal Tobacco Control, is the necessity of the journal’s guidelines to adhere to a specific writing format. This does have some advantages in keeping the debate over an article related exclusively to the article. However, there are some respondents that prefer to write an unabridged version of a critique lest the comment not pass the rapid response system for publication.

    There are several advantages to publishing a critique of an article outside the rapid response system [2] that allows for a broader audience to read and respond to both the article content and the critique.

    Personal blogs often reflect the style of the author, and also allow for greater freedom of expression including the use of imagery to illustrate vital points that many readers find both enjoyable and informative.

    Providing a platform within the journal must allo...

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  • Good case for subsidies

    NOT PEER REVIEWED This seems a good case for encouraging rechargeable cigalikes and 3rd generation refillable systems in the locations that charge a low cigarette tax.

    Time for subsidies?

  • Chairperson New Nicotine Alliance Sweden/Press Officer INNCO.org

    This is a test message to ascertain if BMJ and Tobacco Control have gotten the rapid response feature up and running. If so this message should appear and those scientists globally wanting to file responses will be immediately alerted that this is now possible. The essence of any critique I personally may have with the BlogFog article is summarized in my declarations of intellectual COI. Submitted March 2nd, 2017.

  • Disappointing retreat from the public square

    The editors of this journal, Tobacco Control, argue in their blog that debate about published articles should be concentrated on their rapid reaction facility. It is possible that they are making a constructive invitation to their critics to join a debating platform they might otherwise be wary of. However, the blog has been widely read as disparagement of other forms of engagement, notably social media and blogs. It is possible that the editors do not fully appreciate why people use blogs and social media to respond to papers they find problematic, and not Tobacco Control's rapid response feature. Here are several reasons:

    1. Trust

    Critics may consider, rightly or wrongly, that Tobacco Control has a track record of publishing papers that have dubious scientific merit, overconfident conclusions and policy recommendations that cannot be supported by the paper - almost always reinforcing a particular (abstinence-only) perspective. Critics may be concerned that their work will be treated unfairly or sidelined, or that they will be judged or ridiculed. They may distrust the editors, believe the journal is not impartial, or hold it in low esteem.

    2. Conflict of interest and incentives

    Not everyone is content to have their reactions edited or approved by the same people whose work they are criticising. Once a journal has published an article that is open to criticism, it develops a conflict of interest between its own r...

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  • Request for a few important clarifications

    NOT PEER REVIEWED The authors of this editorial assert that a journal article’s authors are “entitled to be aware of and respond to critiques”, and imply that this is only possible if critiques appear in a forum attached to the journal. Setting aside the fact that authors can easily become aware of and respond to critiques on other forums, I am curious if the authors could offer some basis for claiming such an entitlement? It seems quite contrary to all existing laws, principles of ethics, cultural norms, and standard practices that relate to commentary about published work. Moreover the behavior of many of these very authors suggests they are willing to go to great lengths to avoid being made aware of critiques.

    It seems safe interpret the statement as saying that at least these particular authors would like responses to their work to appear on this page. And so, I am fulfilling their request. (Assuming this is allowed to appear, that is. I say that not because I believe there is anything in this comment that would warrant censorship, but to emphasize the blindness of this process. That is, the commentator really has no idea what will be allowed to appear.) I call the authors’ attention to two blog posts I have written critiquing this editorial to ensure they have the requested opportunity to be aware: https://antithrlies.com/2017/02/20/editors-of-t...

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  • The value of this largly depends on the willingness to publish comments

    While I would agree that comments that are directly applied to the article in question are better than blogs scattered across the internet, this policy is entirely dependent on the willingness of editors to publish critical comments that may not be formatted or composed in a style that they are entirely comfortable with. Will editors provide feedback to, for example, citizen activists on why their comments were not published, and how they could change them to make them more acceptable? This seems unlikely, and will only reinforce the perceived inequality of position.

    I would also be moved to wonder how editors will deal with rapid responses that link to lengthier works elsewhere? For example, the format of the rapid response does not lend itself well to appending images, which can often be useful to highlight problems.much more effectively than text.

    A more likely outcome of this policy is, I fear, an increasing separation into two echo chambers with no overlap, and with far too little exchange of thoughts between the proponents and opponents of vaping, to the detriment of the vast majority who are neither,

  • Prevalence of e-cigarette prevalence among Korean adolescent is decreasing
    Hong-Jun Cho

    NOT PEER REVIEWED This ad watch shows an interesting example of illegal marketing activity of an e-cigarette company in Korea. However, the description of the trend of e-cigarette prevalence among Korean adolescents is not correct. According to the national annual surveys that the author quoted (reference 4), prevalence of current (30-day) e-cigarette use among Korean adolescents was 4.7% in 2011 and 5.0% in 2014. It decre...

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  • Cigarette Butt Waste and Resolution
    Dave Conlin

    NOT PEER REVIEWED Back when I used to own property with several hundred feet highway frontage, I was distressed to find and pick up an average of 50 or more butts along my property every time I walked the perimeter.

    I thought about the bottle deposit idea as a solution, but many simply won't care and the unrefunded deposits end up as an added profit for the manufacturer.

    Why not mandate a special plas...

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  • Natural Cigaretts
    Kim C

    NOT PEER REVIEWED Why is the LGBT at greater health risk?? and why was it necessary to even add that?? This makes me very upset that we are "targeted" as such! How is this.. or was this part of the study?

    Conflict of Interest:

    None declared

  • Re:Bauld et al omit evidence on passive exposure to e-cigarette aerosol
    Sarah Jakes

    NOT PEER REVIEWED David Bareham cites 'Rip Tripper' as evidence that e-cigarette users report experiences of allergies being exacerbated in non users by vapour and describes Mr Tripper's subsequent rather mangled argument that the devices should not be used in enclosed public spaces as "eloquent".

    Perhaps Mr Bareham is unaware that Mr Tripper has also claimed that vaping causes limb cramps and dry knuckles which...

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  • Methodological pitfalls in the measurement and decomposition of socioeconomic inequality of smoke exposure
    Guido Erreygers
    NOT PEER REVIEWED I would like to point out a few disturbing inaccuracies in the methodology and interpretation. Since the health variable is binary, the authors apply "Wagstaff's correction" to the Concentration Index. This is a perfectly legitimate decision, but the authors mistakenly suggest that this correction can be applied to both the relative and the absolute version of the index, yielding two normalized indices. In fact,...
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  • Flavor Profiles
    Kenneth H Kawa

    NOT PEER REVIEWED When it comes to vaping my knowledge is somewhat advanced, in the hardware aspect I am in the forefront of technology, I test prototypes and beta models for manufacturers all around the globe, I also have acquired quite a bit of knowledge when it comes to the creation of flavors.

    There's a big difference between something you like and what is referred to an "All Day Vape" or ADV and the impact t...

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  • This is a perspective through a warped lens.

    This is not a particularly well constructed argument. In particular, the paragraph that states:
    "If ENDS emissions were really benign, indoor vaping advocates should take courage and call for it to be allowed in classrooms, crèches, hospitals and neonatal wards. That they do not rather suggests that they know well that such a position would be irresponsible."
    is possibly the worst excuse for a genuine point of debate it has ever been my misfortune to encounter. it is not even a particularly well constructed straw man.

    Many things are considered normal and appropriate for the general population that would not be considered appropriate for a crèche, classroom or neonatal ward.

    To use merely the first two examples that sprang to mind (and the list is almost endless):
    Incense sticks are widely used, and despite the clear emission of smoke, they are are not banned, or the subject of proposed bans, in most jurisdictions. Many people use them, but I doubt that any would do so in a crèche or neonatal ward. Yet, if we follow the same logic proposed here, this means that they are dangerous, and should be banned almost universally.
    Similarly, fog machines are widely used in stage shows, nightclubs and even teenage discos. Despite the extremely strong similarity with vaping, both in chemical composition and particle size, there are not widespread calls for fog machines to be banned (I'm certainly not aware of...

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  • Bauld et al omit evidence on passive exposure to e-cigarette aerosol
    David W Bareham

    NOT PEER REVIEWED The American Indoor Hygiene Association (AIHA) i.e. Experts in in this particular field on passive exposure, have, previously, concluded conversely to Bauld et al (1). As they state:

    "If the only individual affected by using e-cigarettes were the vaper, the discussion could end here. That is not, however, the case. Similar to secondhand smoke, the ingredients exhaled by the vaper include nicot...

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  • Indoor vaping and brochodilator use are not analogous
    Simon Chapman

    NOT PEER REVIEWED Bauld et al [1] draw an analogy between indoor vaping and the use of bronchodilators for asthma ("if and when vapour products with a medicinal license become available, it will be important to allow their use indoors, just as asthma inhalers, which dispense a drug and propellants into the atmosphere, can be used indoors.")

    Surely, they cannot be serious here?

    Newman et al showed the a...

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  • Internet cigarette vendors make tax free claims and selling cigarette cheaper:An alarming isssue
    Md Abu Bashar

    NOT PEER REVIEWED The Internet is widely used source for purchasing and selling products. However,purchasing tobacco products online is a new trend. The internet vendors are often exempted from taxes leading to lowering the cost of cigarettes in certain countries.This is a really alarming situation as it would lead to increase in sales of tobacco products due to lower prices. Countries need to check this trend otherwise al...

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  • Intent-to-treat analysis of observational studies assessing electronic cigarettes' efficacy as an aid to smoking cessation.
    Ivan Berlin

    NOT PEER REVIEWED In the last decade, electronic cigarettes (EC) have become increasingly popular in particular among smokers. Most EC users choose to use nicotine containing liquids (electronic nicotine delivery system, ENDS); these ENDS can be considered as similar to nicotine replacement therapies. Among the several questions EC use raises, one is of major importance: Are EC a smoking cessation aid and if yes to...

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  • Impact of e-cigarette adverts on children's perceptions of smoking
    Deborah Arnott

    NOT PEER REVIEWED The study conducted in England by Petrescu and colleagues [1] concludes that there is a "potential for e-cigarette adverts to undermine tobacco control efforts by reducing a potential barrier (i.e. beliefs about harm) to occasional smoking". Clearly it is important to keep monitoring the impact of advertising, particularly on children, and this research paper is a welcome contribution. However, i...

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  • Indoor air laws and hookah smoking
    Sandra S. Retzky
    The authors rightly point out that loopholes exist in some smoke-free air laws, exempting smoking of ???tobacco-free or herbal hookah products??? in public places.
    In New York City, where this study took place, the governing laws are: (1) New York State Clean Indoor Air Act, and (2) New York City Smoke Free Air Act.[1] Between 2002-2003, both laws were amended to "prohibit smoking in virtually all in...
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  • Addiction refuses to allow discussion of industry ties to criticism of our paper
    Margarete C. Kulik

    NOT PEER REVIEWED In June 2015 we published our paper "The smoking population in the USA and EU is softening not hardening" in the journal Tobacco Control. We showed that as smoking prevalence has declined over time, quit attempts increased in the USA and remained stable in Europe, US quit ratios increased (no data for EU), and consumption dropped in the USA and Europe. These results contradict the hardening hypothesis whi...

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  • Response to article
    Elizabeth L Allen

    NOT PEER REVIEWED I am writing in response to sight of an article published by you about my work for the International Tax and Investment Center (ITIC). The ITIC guidebook published in 2011 "The Illicit Trade in Tobacco Products and How to Tackle it" makes it clear in the Executive Summary that it is "a compilation of facts and views from a wide range of sources including respected academics, private sector consultants,...

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  • Cigarette butt removal turned into business
    Manfred Neuberger
    Any cooperation of municipalities with the tobacco industry is problematic. In Vienna, the capital of Austria, the department responsible for waste made a deal with the tobacco industry. This resulted in the installation of metal tubes for cigarette butts at every tram station, resembling huge cigarettes. Now there are still butts on the floor (usually extinguished by foot), but in addition, smoke is escaping from many of these as...
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  • Re:Reply to Does smuggling negate the impact of a tobacco tax increase?
    Tat Chee Tsui

    NOT PEER REVIEWED Thanks for Mr. Middleton's information that there are local tobacco manufacturers in Hong Kong. I made a mistake when reading the materials. I have amended this in the updated version.

    It does not affect the analysis as the government taxes based on number of cigarettes sold rather than manufactured, but I sincerely appreciate your valuable advice.

    For the analysis part, it is not easy...

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  • a possible solution?
    steven m. bergey

    NOT PEER REVIEWED Pressure the CDC and FDA to pressure state legislatures to outlaw the sale of filtered cigarettes. As I see it, this is the only viable solution for ending this litter problem. Cigarette smoking should be made as unappealing as possible to all concerned.

    Conflict of Interest:

    None declared

  • Missing the point
    Clive D. Bates

    NOT PEER REVIEWED The author appears to believe that the main problem with the FDA is that it is not doing enough to prevent new niche cigarette products reaching the market. This focus of concern is misplaced, given several thousand cigarette products are readily available and smokers are spoilt for choice with or without these new products. I have no great desire to see new cigarette products coming on the market, but is this...

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  • Corroborating experimental study finds no effect of e-cigarette advertisements on interest in or susceptibility to tobacco smoking or e-cigarette use
    Leonie S Brose

    In a smaller sample of older teenagers, I recently extended and replicated some of Vasiljevic and colleagues' findings [1]. In line with their results, I found that e-cigarette advertisements did not increase interest in tobacco smoking, interest in using e-cigarettes or susceptibility to either behaviour.

    In this experimental study, 65 UK non-smokers aged 16-19 years were randomised to viewing either six e-ci...

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  • Other Possible Supplements to Cigarette Warning Labels?
    Eric N. Lindblom

    It is enormously helpful when researchers consider new, not-yet-tried tobacco control interventions (such as this study's consideration of warning messages on cigarette sticks), especially when researchers figure out effective ways to evaluate the not-yet-tried interventions.

    Some additional possibilities related to new warnings or pack changes that might be considered:

    (1) Put instructions for use in...

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  • Reply to Does smuggling negate the impact of a tobacco tax increase?
    James Middleton
    NOT PEER REVIEWED This article is manifestly wrong in material content. Hong Kong has in fact, two current large domestic manufacturers of tobacco products, Hong Kong Tobacco Co Ltd and Nanyang Brothers Tobacco Co Ltd. Moreover the HK Customs Dept are all over the local dial-up-delivery smuggling syndicates to the extent that the tobacco funded front groups ITIC and Oxford Economics had to produce wildly false and flawed Inform...
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  • Response to McDaniel re: Endgame Review and Wake-up Call to the Tobacco Control Community
    Joel L Nitzkin

    NOT PEER REVIEWED The recent endgame review by McDaniel et al1 demonstrates a major flaw in thinking within the tobacco control community. The industry is seen as dominated by the "big tobacco" cigarette companies. The real life industry is intensely competitive and highly fragmented. There are, within the industry, many who could effectively partner with the public health community, if given the opportunity to do so. Bec...

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  • Re: Raising the Minimum tobacco sales age to 21- worth a try?
    Olatokunbo I Osibogun

    To the Editor,

    Despite the seemingly decline in tobacco use, the habit is picked up by youths on a daily basis. According to the CDC fact sheet, tobacco use is established primarily during adolescence where 9 out of 10 cigarette smokers first initiate smoking by age 18. In the United States, more than 3,800 youths aged 18 years or younger try their first cigarette every day [1]. If the trend continues, about 5....

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  • Letter to the Editor: Analytical concern regarding the measurement of weight control beliefs.
    Kristopher O. Myers

    NOT PEER REVIEWED To the Editors, In the article entitled, "Weight control belief and its impact on the effectiveness of tobacco control policies on quit attempts: findings from the ITC 4 Country Project" I noticed a problem regarding the measurement of weight control beliefs. This variable (weight control beliefs associated with tobacco use) is measured using only one question. The researchers indicate, "In order to iden...

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  • Beyond tobacco to divesting from eco-destructive resource and industrial sectors
    Joseph Ting

    NOT PEER REVIEWED To the Editor:

    Beyond the plea to divest from funding tobacco companies, shareholders need to consider the adverse impact of investing in industries and resource extraction that worsen eco-degradation.

    At a group level, the impetus for environmentally accountable investing by colleges and universities can be better maintained by teaching every student the practical ways to minimize th...

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  • Assessing Google Trends Data for Electronic Nicotine Delivery System Interest
    Ashley L. Merianos

    NOT PEER REVIEWED Cavazos-Rehg et al. compared the results of Google Trends relative search volume (RSV) data for non-cigarette tobacco use with data from state- and national-level youth surveys.[1] Given the authors' findings of positive correlations with Google Trends and survey data, we agree with the conclusion that Google Trends may be a potential tool to provide real- time monitoring for non-cigarette tobacco use. T...

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  • RE: Estimates of the economic contributions of the bidi manufacturing industry in India
    Krishna Raghunandan

    NOT PEER REVIEWED I read the research paper (other authors Ashvin, Emmanuel, Frank and Prabhat) with interest.

    Quite a few new points have been brought out. One of the important political reasons for resistance is that hand made ones are done in rural areas where alternate means of employment are hard to come by. This results in the local political representative arguing against tax.

    Alternatives such...

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  • Response to E-Letter from May 6, 2015
    Sumit R. Kumar

    NOT PEER REVIEWED We explicitly did not do a systematic review, which would have included things such as assessing articles for quality and assessing for presence of publication bias. Instead we opted for a narrative review. This decision was made given the limited time available for the authors to complete the supplement prior to the World Conference on Tobacco or Health and the small number of available articles after ou...

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  • These are not real-world conditions.
    Dimitrios Gazis
    NOT PEER REVIEWED "The GC temperature programme for all analyses was: 35C hold for 5???min; 10C/min to 300C; then hold for 3.5???min at 300C." Water is not dangerous. Yet, if I submerge a human test subject in a container of water for 3.5 minutes, then this water becomes quite lethal. No vaping device is intended to run continuously for longer than a few seconds. Furthermore, 300C is far too high a temperature for any vaping de...
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  • Questions asked and answered
    Jonathan D. Heck

    This letter responds to misrepresentations in a recent article by Daniel Stevens and Stanton Glantz (1). In the article, Stevens and Glantz question my integrity based on some questions during a 4-day deposition which I gave in 2014 in a legal proceeding against my employer. These writers cite snippets from the 1,000+-page transcript of that deposition, relating the text of a facetious note that I h...

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  • Re:No evidence that the tobacco industry evaded the FDA's ban on 'Light' cigarette descriptors
    Hillel R Alpert

    NOT PEER REVIEWED This comment summarizes, but mischaracterizes the findings and conclusions of our study. Our analyses and interpretation are based strictly on the letter of the Family Smoking Prevention and Tobacco Control Act (FSPTCA) and its requirements, including Section 911(b)(2)(ii), which bans "the use of explicit or implicit descriptors that convey messages of reduced risk including 'light', 'mild' and 'low', o...

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  • Review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure - Letter
    Luis D Ramirez

    NOT PEER REVIEWED Dear Editor,

    Research on waterpipe smoking, also called hookah, is still emerging, and research on second-hand hookah exposure is still in its nascent stages. However, after reading the review on the various effects of second -hand waterpipe smoke exposure by Kumar et al recently published in Tobacco Control1, we noted several major issues in its execution and have serious reservations about th...

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  • An update on smoking prevalence projections to 2025 and beyond in New Zealand
    Frederieke S. van der Deen

    Frederieke S. van der Deen and Nick Wilson (on behalf of the other authors; both from the University of Otago, Wellington, New Zealand)

    This electronic letter aims to give readers an update on the smoking prevalence projections to 2025 and beyond in New Zealand (NZ) that were provided in the paper by Ikeda et al. NZ is now one of four nations with an official smokefree goal (others are: Fin...

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  • Tobacco industry peddling overestimates of illicit cigarettes to dampen tax increase
    Sophapan Ratanachena


    We refer to the article, "Did the tobacco industry inflate estimates of illicit cigarette consumption in Asia? An empirical analysis" Chen J, et al. published in Tobacco Control on November 25, 2014 (Tob Control 2015;0:1-7) and concur with the important points raised in this article. While the article focuses on Hong Kong, other countries in South East Asia also faced a similar experience. The...

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  • Cook Islands data: some information and comment
    Erik Martin

    NOT PEER REVIEWED I commend the authors on a significant effort involved in conducting this rather insightful research.

    Having conducted qualitative research on FCTC implementation in the Pacific, I can provide comment in relation to the Cook Islands which may explain why MPOWER measures mentioned here did not achieve decreases in prevalence (at least in the figures obtained in this study).

    Firstly, th...

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  • Consider health-related outcomes when assessing the equity impacts of smoking ban policies
    Sericea Stallings-Smith

    NOT PEER REVIEWED We welcome the timely review published by Hill et al. [1], and agree that more research is needed to assess the equity impacts of tobacco control interventions. The results of the review indicated that "increases in tobacco price have a pro-equity effect on socioeconomic disparities in smoking", but that "evidence on the equity impact of other interventions was inconclusive [...]". The inconclusiveness o...

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  • Taxation may help, but perhaps new thinking is needed?
    Kristiina Patja

    NOT PEER REVIEWED Tobacco is an interesting consumer product. It is legal, toxic and dangerous. It kills people when used as intended. There is a global initiative to reduce use of this product opposed heavily by those profiting from it, tobacco industry stockowners. Industry has successfully blurred consumers, health professionals and policy makers over the years with false science, modulation of product and misleading m...

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  • Working toward a more sophisticated conceptualization of health and trade
    Jeffrey M Drope

    In this rejoinder, we will address the recent response by Mary Assunta to our article, "Complexities at the intersection of tobacco control and trade liberalisation: evidence from Southeast Asia." To be sure, we believe that trade policy remains a very important issue for public health both in Southeast Asia and globally. Before addressing the specific concerns raised by the reader, it is worthwhile to restate the ove...

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  • A tobacco carve-out is the way for the future
    Mary Assunta

    I would like to respond to this paper by Drope J and Chavez JJ whose analysis focuses on cigarettes, not tobacco leaf production and trade, and seeks to question the "conventional wisdom" that "trade liberalization naturally leads to lower prices for tobacco products, increased consumption and decreased levels of regulation." The authors use theoretically guided empirical research to demonstrate there is little cause for...

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  • Silver linings and improvement of our resources for smoking cessation interventions.
    Pasquale Caponnetto

    The article of Cummins et al. (1) is based on a survey which according to the authors considers electronic cigarette a risk for populations with mental health conditions. First of all, in our opinion it is not correct to agglomerate and treat all mental health conditions in the same way. It would be like considering all physical illness the same way. Fever is like a cancer? A specific phobia is like schizophrenia? It 'is...

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  • An impartial, independent and transparent process
    Zora Milenkovic

    Euromonitor International is a world leader in strategy research for consumer markets, with over 40 years of experience in developed and emerging economies. Through a combination of specialist industry knowledge and in-country research expertise, Euromonitor aims to build a market consensus view of the size, shape and trends in each industry we cover. Tobacco is no different, and both duty paid and illicit sales are rese...

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  • FDA has definitively lost its way.
    Alain Braillon

    Gottlieb rightly provides us evidence to question Food and Drug Administration (FDA) policy.(1) Indeed, the 2009 law giving the Agency the authority to regulate tobacco was useless as FDA's Advisory Committee issued a report which failed to recommend a ban on menthol cigarettes despite evidence of its devastating effects, a major setback for public health.(2) Is FDA only overcautious as Gottlieb suggested? Its professio...

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  • An analysis of limitations of tax policy is not a policy fix
    Stephen L Hamann

    It is important for tobacco control policymakers to know the advantages and disadvantages of different tax policies. It is quite another thing to move a tax system to optimize tax policy for tobacco control since there are multiple obstacles to systems change. In addition, health advocates often do not invest enough time and effort to understanding the economics of tax systems and the structural impediments in existing l...

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  • Re:KPMG response to 'Towards a greater understanding of illicit tobacco trade in Europe: a review of the PMI funded 'Project Star' report', published in Tobacco Control (BMJ) on 11th December 2013
    Anna B Gilmore

    Dear Editor

    Cartwright (1) has clearly mis-read our article on PMI's Project Star report(2). The central premise of our article is not that illicit is overestimated but that the Project Star report cannot be relied on as a source of data on illicit until there is significantly greater transparency over the underlying methodology and data inputs and the contractual arrangements under which it is conducted. KPMG i...

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  • KPMG response to 'Towards a greater understanding of illicit tobacco trade in Europe: a review of the PMI funded 'Project Star' report', published in Tobacco Control (BMJ) on 11th December 2013
    Robin M. Cartwright

    Significant factual inaccuracies relating to KPMG's annual report into the European trade in illicit tobacco were made in a recent article published in Tobacco Control by the BMJ. The report, which KPMG's Strategy Group has been producing since 2005, is recognised by the UK National Audit Office, OLAF and the OECD (and by other numerous national customs authorities and government departments) as the most comprehensive...

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  • Cultural considerations for tobacco control strategies in rural China
    Diana M. Sheehan

    NOT PEER REVIEWED Dear Editor,

    The recent article by Cai et al, reported that male gender, young age, low educational attainment, and tobacco cultivation are predictors of tobacco use and second-hand smoke (SHS) exposure in rural China [1]. Neighborhood-level income was the only contextual predictor of tobacco use and SHS exposure identified. Hence, the authors suggested that "future interventions to reduce smo...

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    Mohamed F. Allam

    NOT PEER REVIEWED To the Editor: The habit of water pipe smoking is rapidly extending in all occidental countries. This rise in popularity appears to be correlated with the advent on store shelves of an array of fruit-flavored tobacco mixtures, which list ''molasses'' as a primary ingredient. Also there is a widespread misperception among smokers that the water through which the smoke bubbles acts as a filter, rendering...

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  • Taking Breaks: are smokers examples of model employees?
    Ivan L. Gee
    NOT PEER REVIEWED The article by Berman et al "Estimating the cost of a smoking employee" has attempted to quantify the costs associated with employing smokers. As the article indicates several companies are now actively discriminating against smokers so it is important that any costs are fully justified. One area that concerns me about this is a tendency towards oversimplification of a complex situation. In particular the assu...
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  • Re:Measuring mass media coverage of tobacco: prominence over quantity
    David E. Nelson

    We appreciate Dr. Blum's interest in our study and his comments. Data used for our study were collected and coded based on the public health surveillance model, which is more fully described elsewhere (1). Only a carefully selected set of items from tobacco news stories were coded over an extended period of time, with editorial cartoons and letters to the editor not included in the system. The newspapers were specific...

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  • Measuring mass media coverage of tobacco: prominence over quantity
    Alan Blum

    NOT PEER REVIEWED Because the authors cite just seven major tobacco-related news events in the seven year period they reviewed (Figure 2), I question whether their tabulation of the "volume of news media stories on tobacco" (page 6) provides a meaningful representation of the coverage of tobacco-related issues in the mass media. Is not a front-page article on a tobacco- related subject in The New York Times or The Washingt...

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  • Re:Re:Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control
    James A McLennan

    NOT PEER REVIEWED I really welcome this kind of discussion.

    I acknowledge your 'why and how' argument, however you may find that things like telephone counselling and many group programs will however then fall into your unassisted quitting category as well. This is because they are simply being coached to enhance those natural skills they already have.

    I am aware you are conducting an interview style...

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  • start a broader movement targeted at WTO
    Manfred A. Neuberger

    NOT PEER REVIEWED The warning of this article is important, but not limited to the Trans-Pacific Partnership. Switzerland and USA, as countries which have not ratified, are not obliged to follow Article 5.3 of the WHO Framework Convention on Tobacco Control. One of the reasons for the largest tobacco companies to move their headquarters to Switzerland was the location of the World Trade Organisation in this country. Some...

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  • Gutkha-Ban (commercial brand of STs) in India is not implemented properly
    Chitta R CHOWDHURY

    NOT PEER REVIEWED Smokeless Tobacco(ST) such as Gutkha-ban (and the like) in India does not work!

    There have been repercussions from sections of growers following the ban of Gutka (and similar products) in Karnataka, a South -Western state of India with the highest production of Areca-nut (one of the major constituents of ST, used in commercial sachet (such as Gutka etc) and home-made/vendor-made Tambula/Paan...

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  • Report ignores key issue in tobacco end game: smokers with behavioral health comorbidity
    Jill M Williams

    The prospect of a tobacco endgame in which death and disease from tobacco would be virtually eliminated is very exciting. We read the May 2013 issue of Tobacco Control on the Tobacco Endgame with great interest. The issue features 20 articles by esteemed co-authors who are known internationally for their work on tobacco control. Each individual article is excellent; however, we were surprised and disappointed that thi...

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  • Important differences not significant and risk negligible
    Jonathan H Bagley
    NOT PEER REVIEWED Surface nicotine levels in non-smoking rooms of smoking and smoke-free hotels were found to be significantly different. However, the authors found that "Geometric mean urine cotinine levels did not differ between non-smoking confederates staying in non-smoking rooms of smoke-free and smoking hotels." Therefore surface nicotine is not important. No significant difference was found between air nicotine levels, w...
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  • Protecting youth and addicts from the neo-nicotine industry
    John R. Polito

    NOT PEER REVIEWED Sincere thanks, Dr. Borland, for your insightful comments recognizing the inherent conflicts between harm elimination and reduction, between policy and profits. As a nicotine cessation educator monitoring the latest wave of irresponsible harm reduction marketing, I have grave concerns that we are only one youth fad away from seeing adolescent nicotine dependency rates skyrocket.

    Nicotine addic...

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  • Re:Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control
    Simon Chapman

    NOT PEER REVIEWED Jane, We of course agree that smokers who decide to quit do not make that decision in information environments devoid of all the sorts of influences you list. We both have spent decades contributing to those influences. Those influences are "why" people make quit attempts, but by assisted and unassisted, we are referring to "how" they quit. It's unlikely that many smokers would answer a question on how t...

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  • Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control
    Jame A McLennan

    NOT PEER REVIEWED Simon and Melanie,

    Thanks for the article. With respect, i'm not convinced by your arguments here however.

    Firstly, it is incorrect to broadly assume that millions upon millions of people in the 'real world' quit smoking unassisted. Some of them may have, but most would have been given some kind of assistance, albeit even if very brief. It may be advice from their GP, watched telev...

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  • No evidence that the tobacco industry evaded the FDA's ban on 'Light' cigarette descriptors
    Steven D Pinkerton

    NOT PEER REVIEWED The authors of "Has the tobacco industry evaded the FDA's ban on 'Light' cigarette descriptors?" examined four distinct indicators to address this research question. They found that: (1) the major cigarette manufacturers removed the terms explicitly stated in the Family Smoking Prevention and Tobacco Control Act of 2010 by switching to colour terms (e.g., Marlboro Gold) to designate sub-brands; (2) the...

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  • Smoking scenes in Japanese comics (manga)
    Hiroshi Kawane
  • Re:Consequences of TC policy
    Naseem A. Qureshi

    NOT PEER REVIEWED Prof. Ruth Malone is a real, well known catalyst in controlling use of tobacco worldwide. Now her one very sharp weapon to control tobacco use is to implement a policy in terms of rejecting tobacco industry funded research manuscripts publication. There are currently hundreds of thousands of journals including open access journals and are these journals going to follow the steps of TC policy of TCJ? If t...

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  • Implementing Tobacco Control's policy on tobacco industry-funded research.
    Alain Braillon

    NOT PEER REVIEWED The decision to ban tobacco industry-funded research in the Journal could be the opportunity for pointless byzantine discussions from the pros and cons.(1) However, the issue is more concrete. First, Ruth Malone acknowledged the editorial board for vigorous discussions and I would like to know how many members opposed the ban. Second, what is the definition of a tobacco industry for the Journal? Cancer R...

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  • Consequences of TC policy
    John Hughes

    Although I disagree with TC's policy to prohibit publication of research from the tobacco industry, I do understand the rationale for this decision. My concern is illustrated by the following scenario. Assume a pharmaceutical company owned by a tobacco industry has truly developed a safer tobacco/nicotine product; e.g. a nicotine inhaler, submits it to the US FDA or the UK MHRA. Both of these agencies have stated they w...

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  • Response to "Indoor exposure limits?"
    Sean Semple

    Dear Editor,

    We are grateful that the eLetter from Ms Cunnison provides an opportunity for us to clarify some aspects of our work [1].

    In the past there has been no authoritative guidance on the protection of public health from risks from particulate matter (PM) in indoor air. It is therefore a welcome development that the recent WHO Air Quality Guidelines for Indoor Air [2] concluded that there is no...

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  • Theoretical and documented safety issues concerning electronic cigarettes
    Konstantinos E. Farsalinos

    NOT PEER REVIEWED In this interesting study by Cheah et al,1 the authors have raised several safety issues concerning electronic cigarettes. The majority of them were based either on the finding that nicotine content was inconsistent or that chemical constitution (for example glycols) may be hazardous to health.

    There is some inconsistency in characterizing polypropylene glycol as "a known irritant when inhaled o...

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  • Indoor exposure limits?
    Belinda Cunnison
    I am a lay person, but curious as to how these conclusions are reached. How is it possible to describe 25 ug/m3 as a WHO _indoor_ air quality standard, when it seems to have been designed as an outdoor standard? More importantly how is it possible to apply the standard to journeys lasting under half an hour, when the standard specifically directs how to deal with short exposure times (http://www.epa.gov/ttn/caaa/t1/memoranda/pmf...
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  • Re:Smoking imagery in movies requires action now
    Bobby j Burke

    Most of us know the people who control Hollywood. Well, the Movie Industry is controlled in a similar manner, by their Cousins. They assist in the production of the films by, having their cancer causing product portrayed as a natural thing that your favorite stars do, so why aren't you? Films should have NO tobacco products in them whatsoever!!! If I had my way, I'd stop all tobacco production. If You want to smoke, grow...

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  • Tobacco industry efforts to influence health policies.
    Alain Braillon

    Smith et al provides us with a remarkable review of tobacco industry efforts to influence tobacco tax which deserves several comments.(1)

    First, such efforts can be quite successful as in France: From February 2004 to September 2012 there was no increase in tobacco taxes, accordingly cigarette sales remained unchanged and smoking prevalence of the youngest increased during Sarkozy's presidency, an exception amon...

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  • Re: "Are functional beliefs about smoking a proxy for nicotine withdrawal symptom reduction?" by Gillian S Gould, Alan Clough, and Andy McEwen
    Omid Fotuhi

    Omid Fotuhi,1 Geoffrey T Fong,1,2 Mark P Zanna,1 Ron Borland,3 Hua- Hie Yong,3 K Michael Cummings4

    1. Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada 2. Ontario Institute for Cancer Research, Toronto, Ontario, Canada 3. The Cancer Council Victoria, Melbourne, Victoria, Australia 4. Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA

    Email for l...

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  • Study Violates Ethical Principles of Research Conduct
    Michael B. Siegel

    NOT PEER REVIEWED This study violates basic ethical principles of research conduct because it exposes children to unreasonable and unnecessary risks, intentionally encourages parents to put their children at risk, and fails to incorporate alternative methods that would reduce these risks.

    The Helsinki declaration states that:

    "The benefits, risks, burdens and effectiveness of a new intervention must be...

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  • Genetic susceptibility testing to lung cancer and outcomes for smokers
    Robert P Young

    NOT PEER REVIEWED We wish to comment on the findings of Smerecnik et al.1 with respect to significant advances in genetic testing , which are highly relevant to their review. Unlike the early single genetic marker tests analysed by Smerecnik et al.,1 where subjects are dichotomised to positive or negative results, genetic susceptibility tests for lung cancer are now multivariate risk tests.2 These new risk tests incorpora...

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  • Are changes in functional beliefs about smoking a proxy for nicotine withdrawal symptom reduction?
    Gillian S Gould

    NOT PEER REVIEWED Fotuhi et al concluded in their interesting study of patterns in smokers' cognitive dissonance-reducing beliefs that rationalisations about smoking change systematically with changes in smoking behaviour(1). Moreover, they argue that: i) changes in attitude on quitting are higher for 'functional' beliefs rather than 'risk-minimising' beliefs and ii) if smokers relapse these functional beliefs return to p...

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  • Brazil's COP4 Delegation disagrees with the conclusions of the research paper "Tobacco industry's fight ITGA FCTC Implementation in the Uruguay negotiations"
    Tania Maria Cavalcante

    The author seeks to analyze the interference of the International Tobacco Growers Association (ITGA) in the decisions of the 4th Conference of the Parties (COP 4) on the Framework Convention on Tobacco Control (FCTC) regarding Guidelines recommending the prohibition of additives in cigarettes and includes Brazil as one of the countries influenced by this organization. As members of the Brazilian del...

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  • Corrections to citations and interpretation of Hughes, et al
    John R Hughes

    I would like to make one correction and some comments on this article's interpretations of our prior review article on hardening (Drug Alcohol Dependence 117:111-17, 2011).

    The Cohen et al article cites the prior review as treating "tobacco control policies solely as a driver of quit attempts, with no impact on the ability to maintain abstinence after a quit attempt (p 266)." The article actually stated "...

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  • Limited Sampling and lack of social group can effect the comparison of cigarette- and hookah-related videos on YouTube
    Atif A Baig

    NOT PEER REVIEWED We want to share our thoughts regarding the conclusions of this comparison. We strongly believe that this research must be evaluated with a larger sample. The criteria for inclusion or exclusion need to be revised, for two reasons:

    1. If we search for videos on Youtube using the words "cigarette" or "hookah", there are more than 86,500 and 39,850 videos respectively (search dated, March 15th, 201...

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  • Free NRT by mail an intent-to-treat defeat
    John R. Polito

    Zawertailo, Selby and colleagues conclusion that free replacement nicotine (NRT) by mail is effective is deeply disturbing.[1] While the study's free abstract portrays free NRT by mail as a resounding success (21.4% smoking cessation at 6 months versus 11.6% for no-intervention), it neglects mention that under intent-to-treat analysis that there was zero benefit over no-intervention (an average of 8.7 percent 30-day poi...

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  • Response to Thomson et al.
    Michael S. Givel
    NOT PEER REVIEWED I note this article in Tobacco Control quotes my two recent articles on the Bhutanese endgame. However, the Tobacco Control article to a certain degree does not catch the spirit of what is going on in Bhutan and what I concluded in my publications. Importation of small amounts of tobacco for personal consumption is legal. Sales are not--they are banned nationwide. Nevertheless, there is a major tobacco black mark...
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  • What are U.S. health officials smoking?
    John R. Polito

    NOT PEER REVIEWED Zhu and colleagues' population level findings contribute to a growing body of external real-world evidence supporting the conclusion that the quitting product marketing industry's "double your chances" mantra is false and deceptive, and that smoker reliance upon it is likely responsible for a host of negative consequences, including failure to quit and premature demise.[1]

    Their review of twenty years...

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  • Authors' Response
    Hillel R. Alpert

    The volume of attention to our study in the U.S. and international press is not surprising, considering the widespread promotion of nicotine replacement products to all smokers in the population, and their growing inclusion in government subsidized health plans. Prior to addressing criticisms made by Stapleton and others, we note that their comments reflect at least one important area of agreement. The fact that no adva...

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  • Throwing the baby out with the bath water
    Alain Braillon

    Throwing the baby out with the bath water

    Alain Braillon(a) MD, PhD, Gerard Dubois(b) MD, MPH.

    (a) 27 rue Voiture. 80000 Amiens. France (b) Public Health. Amiens University Hospital. France

    In an observational study Alpert and colleagues concluded that persons who have quit smoking relapsed at equivalent rates, whether or not they used nicotine replacement therapy (NRT) to help them in their qu...

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  • Misreporting of results: Correction of Alpert et al 2012
    Dr Emma V Beard

    In their paper claiming to find that NRT is not effective long-term, Alpert et al [1] misrepresented findings from a paper for which I was primary author [2], citing it as evidence that other representative population studies have not found any beneficial effect of the use of NRT on annual smoking cessation rates. They state 'Beard et al found increased short-term abstinence only (sic) among persons who had reported using...

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  • Online trade of Snus as well as Gutkha (Indian variety of smokeless tobacco-ST) should be banned. WHO FCTC must have a special focus on this deadly threat of oral cancer to millions.
    Chitta R CHOUDHURY, Prof

    Professor Chitta Choudhury Director, International Centre for Tropical Oral Health, UK

    Nitte University Dept of Oral Biology Genomic Studies | Cen Oral Dis Prev Control, Mangalore, India.

    NOT PEER REVIEWED I refer to the report "How online sales and promotion of snus contravenes current European Union legislation, published recently in Tob Control 21 January 2012. Like Snus, the online trade of Gutkh...

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  • Perverse conclusion from results
    John A. Stapleton

    The results of the recent study by Alpert et al. were interpreted incorrectly with respect to the efficacy of nicotine replacement therapy (NRT).(1) The study only considered relative relapse rates among people who had already stopped smoking according to whether they had used NRT or not. This is clearly an inadequate design to address the issue of efficacy because it ignores the initial quit rates in the two groups. Only...

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  • Placebo was never a real-world quitting method
    John R. Polito

    Many of Alpert, Connolly and Biener's population level NRT post- cessation findings are disturbing and worthy of further and deeper review. What's most baffling is that any government would invest so much confidence and so many lives in a product without demanding a shred of population level evidence as to its worth.

    According to this paper, the odds of relapse for a heavily dependent NRT quitter who had quit le...

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  • Is it Population control or tobacco
    Mathew Jose

    Attending the RCP annual conference in 1999 in London, I remember a delegate suggesting during a discussion on tobacco control that providing cheap tobacco could be one way for China to control its population. Though the suggestion was generally felt to be in poor taste, I am shell shocked to read the conclusions of this article !

    Conflict of Interest:

    None declared

  • Butt Perceptions & Butt Solutions....
    Michael J. McFadden

    One would imagine that public concern about butt litter would largely rise with the amount of butt litter that occurs. One would also reasonably imagine that news articles dealing with the "problem" of butt litter would similarly rise. If we take those two assumptions as being a given for the moment, and then look at the statistics uncovered by this research, we see something very interesting.

    Using Google's t...

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  • Reply to Glantz and Polansky
    Simon Chapman

    NOT PEER REVIEWED Glantz & Polansky respectfully suggest that I should (1) "Base my criticisms on actual data and analysis, rather than raising hypothetical problems and presenting them as if they had been demonstrated to be real" and (2) "Criticise the proposal based on the actual behavior of the motion picture industry, not on whether or not youth see some R-rated films."

    Suggestion 1 seems to be proposing...

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  • health warnings unlikely to be effective
    Jonathan P. Krueger

    But the evidence is that no media campaign based on health warnings is likely to be effective.

    So comparing different varieties of campaigns unlikely to be effective doesn't seem very productive.

    Comparing varieties of campaigns using themes known to be effective, might be worthwhile.


    Evaluation of Antismoking Advertising Campaigns Lisa K. Goldman, MPP; Stanton A. Glantz, PhD. J...

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  • Please base criticism on data and analysis, not hypotheticals
    Stanton A Glantz

    Chapman speculates that basing our analysis on box office gross receipts while omitting what he describes as available video revenue data is problematic. However, Chapman does not actually present an analysis based on reliable data that demonstrates that including post-theatrical film receipts would reverse the conclusion drawn in our paper.

    We used industry-reported "domestic" (Canada and United States) gross...

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  • ex-box office income is critical omission
    Simon Chapman

    Glantz and Polansky's paper is titled "Movies with smoking make less money" but it should have continued "... at the box office" because it failed to consider the major sources of revenue to film studios other than from box office receipts (DVD and blu-ray sales, rentals and video-on- demand or iVOD). They write that data from DVD sales and rentals are not available. However, Nash Information Services (which they reference...

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  • Response to Stepanov et al
    Joel L Nitzkin

    To The Editor:

    NOT PEER REVIEWED The allegation by Stepanov et al1 that "regulation of TSNA levels in cigarette smoke should be strongly considered to reduce the levels of these potent carcinogens in cigarette smoke" ignores substantial evidence elsewhere in the literature that suggests that such regulation would do nothing to reduce cancer risk, and, in fact, might increase it.

    Tobacco-specific N-nitr...

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  • Reducing Carcinogenic Tobacco-Specific N-Nitrosamines in Cigarette Tobacco is in the Best Interest of Public Health
    Michael F. Borgerding

    NOT PEER REVIEWED I have read with interest the article titled: Carcinogenic tobacco- specific N-nitrosamines in US cigarettes: three decades of remarkable neglect by the tobacco industry.[1] In the article, the authors suggest that the tobacco industry has not attempted in a meaningful way to reduce or control carcinogenic tobacco-specific N-nitrosamines (TSNAs) either in general (as implied by the title of the article...

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