scholarly journals Productos de tabaco calentado (Heat-not-burn tobacco products): concepciones e implicaciones para la Salud Pública

2019 ◽  
Vol 18 (2) ◽  
Author(s):  
Omar Segura

Objetivo: Explorar necesidades de conocimiento y posibles líneas futuras de investigación sobre los Productos de Tabaco Calentado, PTC (Heat-not-burn tobacco products), desde la literatura científica publicada y las fuentes en internet para el público. Métodos: Estudio mixto cualitativo/cuantitativo paralelo bajo tipología de revisiones de literatura por Grant & Booth y Pinto, y diseño de estudios de mapeo según Cooper. Exploración de bases de datos en motores de búsqueda, cotejo de títulos/resúmenes en 4 idiomas de 2016-12-01 a 2017-12-31. Textos guardados en formatos MHT y PDF, acopiados en Dropbox y gestionados con Endnote X8. Definición de categorías agrupadas en cuatro dimensiones. Información analizada con Microsoft® Excel 2016 y Epi-INFO ® 7.2.2. Resultados: Cotejadas 46 páginas web, 63 referencias científicas, 99% en inglés; 2 manuscritos con nota de retirada. En D1 (sumario): presentación del producto vs. aspectos toxicológicos o evaluativos de PTC. 48 artículos (76,2%) en digital o impreso (2017); por país: EUA: páginas web 23 (50%), 20 artículos (32%); Suiza: 22 artículos (35%), 3 páginas web (7%). D2 (comercial): financiación por Phillip Morris International (PMI, 22; 33%) o universidades con fondos propios/gubernamentales (19, 30%); en páginas web predominaron PMI (60%), British American Tobacco y Japan Tobacco International (40%); relación con PMI ausente en 41 manuscritos (65%) y 36 páginas web (80%). D3 (metodológica): nivel de evidencia “experimental”, laboratorial (26; 41,2%) o en humanos (4; 6,3%); investigación independiente en 36 (57%). D4 (interpretativa): principal interrogante en páginas web fue el carácter dañino o no de los PTC; en artículos científicos, los efectos de micro/nanopartículas de los PTC a mediano/largo plazo. Discusión: Se precisa que la comunidad científica complete los respectivos estudios de toxicidad y reducción del daño (harm reduction) relativos a los PTC y resuelva junto con el público y las autoridades preguntas relativas a su seguridad a mediano y largo plazo.

2021 ◽  
Vol 11 (6) ◽  
pp. 405-415
Author(s):  
S. L. Babak ◽  
M. V. Gorbunova ◽  
A. G. Malyavin ◽  
I. V. Shashenkov

The concept of tobacco harm reduction (THR) is a speculative and controversial topic in the context of the international battle against the use of all types of tobacco. This concept involves providing tobacco users who are unable or unwilling to quit smoking or using other types of tobacco (snuff, chewing), with modified risk tobacco product (MRTP) for continued use. Skepticism about THR is huge and is associated with the negative experience of tobacco companies to produce cigarettes with a low content of tobacco tar/nicotine, which should have had significantly lower health risks than conventional cigarettes. Paradoxically, such an experience served as a springboard to an increase in the number of tobacco products that potentially have the properties of MRTP. Moreover, some members of the anti-smoking coalition, including WHO, consider the transition of tobacco smokers to MRTP as a strategy with great potential. However, the European Group of Experts believes that the MRTP strategy does not work and will lead to another generation of young people getting used to tobacco. In this article, we have critically analyzed the history of the past and present of tobacco products, myths and contradictions around them. We have tried to evaluate the modern concept of S THR as objectively as possible, which has a high potential for a real reduction in the number of deaths associated with smoking.


2021 ◽  
Author(s):  
Cristine Delnevo ◽  
Michelle Jeong ◽  
Arjun Teotia ◽  
Michelle T Bover Manderski ◽  
Binu Singh ◽  
...  

Importance: Physicians play a primary role in smoking cessation, and their communication regarding e-cigarettes needs to be understood. Objective: To examine physician-patient communication regarding e-cigarettes. Design: A national, repeated cross-sectional survey in 2018 and 2019 was conducted. Setting: Participants were invited by mail; surveys were completed online. Participants: Response rates were 51.8% (2018) and 59.1% (2019), resulting in 2,058 board-certified physicians from family medicine, internal medicine, obstetrics/gynecology, cardiology, pulmonary/critical care, and hematology/oncology. Exposures: Physician demographics, tobacco use, medical specialty, and harm-reduction beliefs (i.e., not all tobacco products equally harmful); two hypothetical clinical scenarios. Main outcomes and measures: Physicians' self-reported e-cigarette communication behaviors (being asked about e-cigarettes by patients and recommending e-cigarettes to patients), and hypothetical e-cigarette communication in two clinical scenarios. Results: Among 2,058 physicians, the mean age was 51.6 years and 41.5% were female. Over 60% of physicians believed all tobacco products are equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), while 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [AOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (AOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (AOR, 1.77; 95% CI, 1.12-2.80) had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (AOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (AOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Being asked about e-cigarettes by patients was a strong predictor of physicians' recommending (AOR,16.6; 95% CI, 10.3-26.7). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older, heavy smoker with multiple unsuccessful quit attempts than a younger, light smoker with no prior cessation treatments (49.3% vs. 15.2%, p<.001). Conclusions and relevance: Findings suggest physicians may recommend e-cigarettes for cessation under certain circumstances. Given the role of e-cigarettes in FDA's comprehensive nicotine policy, there is need for continued physician education regarding e-cigarette efficacy, particularly correcting misperceptions regarding harm reduction.


2018 ◽  
Vol 21 (1) ◽  
Author(s):  
Adam Prokopowicz

Psychoactive substance addiction is difficult to treat, brings huge damage to the body and has negative social and economic consequences for the addicted, their families and society. Rehabilitation therapy is often long and has a high failure rate. For this reason, there is a need for extensive action to minimise the negative effects of psychoactive substance use. Substitution therapy is one of the programmes included in the harm reduction strategy. It involves the replacement of an illicit drug with a legal substance with similar or identical pharmacological effects and is applied in drug addiction therapy. In the case of nicotine addiction, substitution therapy involves taking the same psychoactive substance (nicotine) in a form which is devoid of the majority of other toxic substances that are found in tobacco smoke. The introduction of alternative forms of nicotine supply (electronic cigarettes, non-smoking tobacco products) have renewed the controversy around the topic of efficacy of harm reduction involving the replacement of traditional tobacco products with those with reduced emission of toxic substances, but which still deliver nicotine. According to the opponents of substitution therapy, it prevents one from achieving abstinence that allows for full elimination of harm generated by psychoactive substances. Finding a common platform between the proponents of harm reduction and advocates of complete abstinence-based therapy would be of benefit to the addicted individuals.


2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s111-s117 ◽  
Author(s):  
Stella A Bialous ◽  
Stanton A Glantz

There has been a global decline in tobacco consumption that, if continued, will negatively impact the tobacco industry’s profits. This decline led the industry to invent and market new products, including heated tobacco products (HTP). HTP are an extension of the industry’s strategies to undermine government’s tobacco regulatory efforts as they are being promoted as part of the solution for the tobacco epidemic. Under the moniker of ‘harm reduction’, the tobacco companies are attempting to rehabilitate their reputation so they can more effectively influence governments to roll back existing tobacco control policies or create exemptions for their HTP. Rolling back tobacco control policies will make it easier for the companies to renormalise tobacco use to increase social acceptability for all their products. When regulations are absent or when loopholes exist in classifying HTP as a tobacco product (thus subject to all tobacco control regulations), the industry’s marketing of HTP is making these products more visible to the public and more accessible. Governments need to ensure that HTP are regulated as tobacco products or drugs and reject partnerships with the tobacco companies to promote ‘harm reduction’. The tobacco companies remain the vector of the tobacco-caused epidemic and cannot be part of the global tobacco control solution.


2020 ◽  
pp. tobaccocontrol-2020-056058
Author(s):  
Roengrudee Patanavanich ◽  
Stanton Glantz

BackgroundAfter Thailand enacted laws to ban the import and sale of all types of electronic nicotine delivery systems (ENDS, including e-cigarettes and heated tobacco products (HTPs)) in 2015, pro-ENDS advocacy groups pressured the government to lift the ban, particularly after Philip Morris International (PMI) started promoting its HTP IQOS in 2017.MethodsWe reviewed information related to ENDS in Thailand between 2014 and 2019 from Thai newspaper articles, meeting minutes and letters submitted to government agencies, websites and social media platforms of pro-ENDS networks and Thai tobacco control organisations.ResultsThe tobacco industry and the pro-ENDS groups used five tactics to try to reverse the Thai ban on ENDS: creating front groups, lobbying decision-makers, running public relations campaigns, seeking to discredit tobacco control advocates and funding pro-tobacco harm reduction research. ENDS Cigarette Smoking Thailand (ECST), a pro-ENDS group in Thailand, worked in parallel with Philip Morris Thailand Limited (PMTL) to oppose the ban. The group connected with international coalitions that promote harm reduction through the PMI-funded Foundation for a Smoke-Free World.ConclusionAlthough ECST and PMTL continuously worked to revoke the ban since 2017, the government still kept ENDS illegal as of October 2020. This decision resulted from the strong commitment and collaboration among Thai tobacco control organisations and their shared vision to protect the public’s health from harmful tobacco products. The linkages between the pro-ENDS movement in Thailand and the tobacco companies could inform health advocates and policy-makers in other low and middle income countries facing pressure to market ENDS.


2014 ◽  
Vol 15 (4) ◽  
pp. 136-141
Author(s):  
Funda Oztuna ◽  
Zeynep Ayfer Aytemur ◽  
Osman Elbek ◽  
Oguz Kilinc ◽  
Cagla Uyanusta Kucuk ◽  
...  

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