This is a real event that takes place each year in June in Warsaw, Poland. For three days, the Global Forum On Nicotine brings together the scientific community, politicians, the media and the curious around a unique theme: Nicotine. The 6me edition of the Global Forum On Nicotine therefore took place 13 at 15 June 2019 and had for motto It's time to talk about nicotine ("It's time to talk about nicotine"). It is impossible to ignore such an important event, so today we offer you a complete return based on the work of our colleagues Direct Ecigarette . In a second time we will propose you an exclusive interview de Zhou Zhenyi, tobacconist and only official French speaker at Global Forum On Nicotine 2019.
"IT'S TIME TO TALK ABOUT NICOTINE"
For the first time in the history of Global Forum On Nicotine, the lectures were complete! More than 80 speakers were present to intervene on the three days and major specialists in the reduction of smoking risks were at the rendezvous. Each year, the Global Forum is Nicotine is a unique event bringing together lawyers, researchers, policy experts, consumers together to discuss the latest research and regulatory barriers to reduce the risk of smoking.
1ERE DAY: « DISTINCTION MUST ONLY BE BETWEEN COMBUSTION AND NON-COMBUSTION«
On the first day, the major event was Michael Russell Oratory delivered by the Dr. Ronald W.Dworkin, practicing anesthetist, Ph.D. in Political Philosophy, and professor in the Honors program at George Washington University. To recall, the Oratory Michael Russell is an annual event organized to honor the work and memory of Professor Michael Russell, one of the pioneers of the study of smoking, clinical interventions and actions of the authorities, died in 2009.
But before that key moment was held the Consumer Advocacy Meeting with several important points including:
- WHO's opposition to vaping that affects regulation in much of the world
- Advocates who need to focus on networking, clarity of messages and narrating their stories with passion and positivity
The consumer advocacy alignment meeting began with a discussion on COP9 (WHO's ninth Conference of the Parties), and Clive Bates had the opportunity to explain how this type of conference was going. According to him, it is an environment that allows bad policies"It presents this as a room-like environment where people are happy to have done things that will not benefit anyone. Of course, the specter of WHO's vape position was present for much of the session.
Regarding other stakeholders, Tomás O'Gorman discussed the many anti-vape arguments prevalent in Latin American countries, including his country of origin, Mexico. For Africa, Joseph Magero emphasized that people did not have the information needed to make informed decisions about nicotine use. For the Netherlands, Eveline Hondius emphasized that there was no risk reduction policy, that the country was focusing solely on prohibition and complete abstinence, even with respect to vaping.
"It's time to talk about Nicotine" #gfn19 #africa. A big congratulations to the organizers of #gfn19 forum. Thanks for letting us share this experience with fellow enthusiasts & stakeholders of Tobacco Harm Reduction. #SaferAlternatives #NoFireNoSmoke #vaping #Snus #ecigs #Poland pic.twitter.com/yy6kgwYije
- Tobacco Harm Reduction, Nigeria. (@THRNigeria) June 16, 2019
Unfortunately, the message is often that alternatives do not work and that we must be "smoke-free" by 2040. And it is not surprising that Australia has many problems, Fiona Patten (A Reason politician and party leader) pointed out that the Australian Medical Association supported supervised injection sites for heroin users but was totally opposed to reducing risk for smokers.
David Sweanor, professor of health at the University of Ottawa has really summed up the problem by mentioning harmful policies like that of Australia, where vaping is banned, but where cigarettes are readily available. On this day he declares: » We do not want people to play tennis, but it does not matter if they play back and forth with bombs "Which, in a nutshell, is tantamount to questioning the reduction of risks even though smoking is allowed.
When speaking, Clive Bates took the opportunity to make it clear that there should be no distinction between different products (heated tobacco, vaping, snus). In this regard he states: " The key distinction is between combustion and non-combustion (...). As consumer advocates, you are the advocates of all consumers, not just yourself. »
Clive Bates: The funding issue has been weaponized. We have vilified smokers and smoking for 40 years. Money plays an enormous role in anti-vaping anti-THR 'machine. Conflicts of interest are universal. pic.twitter.com/fFGhr9To2K
- Charles A. Gardner, PhD (@ChaunceyGardner) June 14, 2019
During his speech for the Michael Russell Oration, Dr. Ronald Dworkin approached the reduction as a "neophyte" (mixes if the word is a bit loud). According to him, vaping makes it possible to extract a key element of the pleasure of tobacco, thus offering something more targeted where there used to be only "crude" tools. It is a question of pleasure in addition to reducing risks.
His point of view is that people do not necessarily enjoy vaping and or consume slightly (or little) alcoholic beverages because it involves no risk. Yet according to him vaping should have a future and should be appreciated by a good part of the population in the same way that we take pleasure in drinking a good beer.
2EME DAY: OFFICIAL OPENING OF GFN19 WITH DAVID SWEANOR AND AARON BIEBERT
If the first day was somehow an introduction to the Global Forum On Nicotine, the official opening took place the second day presentation speeches of David Sweanor et Aaron Biebert, director " A Billion Live "And" You do not know nicotine".
In this lecture « It's time to talk about nicotine Many topics were discussed, the points to remember being:
- Nicotine brings improvements in some areas including attention and memory, but has disadvantages in terms of stress and mood.
- The potential risks of pure nicotine are generally theoretical, only the dependence is well established.
- Alternative sources of nicotine delivery help smokers to quit, but still attract opposition.
Lynne Dawkins, Professor of Psychology in London addressed this issue by examining evidence regarding smokers and non-smokers. A review of 41 studies concluded that nicotine truly enhances fine motor abilities and aspects of attention and memory, showing benefits for six of the nine areas considered.
However, long-term effects especially later in life suggest that smoking is related to worse cognitive functioning in the long run. Smoking also has drawbacks with regard to stress (smoking does not reduce stress, as many people assume) and mood (relationship with depression).
For its part, Neal Benowitz, an American doctor and professor of medicine at the University of California at San Francisco, specializing in the pharmacology of nicotine and tobacco presented the long-term effects of pure nicotine by assessing each potential risk. According to him addiction is the only "real" problem of nicotine, cardiovascular problems remain considered "probable", while others, such as adolescent brain development problems and cancer, are generally considered as mere possibilities. It also states that if nicotine is not considered carcinogenic, certain effects of the product (for example, the promotion of cell growth) can theoretically lead to cancer.
Peter Hajek, British professor of clinical psychology and director of the tobacco addiction research unit did not seem to agree with his counterpart. For him it is essential to use nicotine to help people quit smoking. He took the opportunity to emphasize that the statement that " nicotine damages the brain of adolescents Does not feature in the many discussions about the risks of smoking, and yet it is one of the most common arguments against the product in the United States. Following his intervention concerns the dual use (tobacco / vaping), according to him, dual users who vapote regularly significantly reduce their consumption of toxins, and do not increase it. This is totally contrary to Stanton Glantz's claims that vaping reduces the rate of quitting.
The following conference presented The regulation of nicotine", The points to remember being that:
- FDA begins to recognize the huge potential drawbacks of its approach
- The situation regarding both the rules of the World Trade Organization and the WHO Framework Convention on Tobacco Control requires legal clarification
- How TPD is applied varies considerably between EU countries
Regarding the regulation of vaping in the United States, Patricia Kovacevic, an expert in smoking risk reduction has reviewed the basics of FDA regulation, litigation updates and the current situation. Most importantly, it highlights the recent admission by the FDA (by Mitch Zeller, its director) that the disappearance of vaping products "would pose serious public health problems».
For the presentation of Dr. Marina Folteaexpert in international trade law and public affairs, the key question was whether electronic cigarettes weresimilar productsTo cigarettes (in the legal sense of the term) for the rules of the World Trade Organization. If this were the case, it will be difficult to treat vaping differently from cigarettes under these rules, and since the legal "tests" of likeness are based on the fact that the products are competing in the market, it is difficult to is more than possible they are. In this situation, the prohibitions could be considered discriminatory by the WTO, unless justified by scientific evidence that "does not exist". In this context, it was pointed out that this could also open the way for severe restrictions on vaping, as this would mean that they would need to be treated in the same way.
Concerning Europe, after a basic introduction to PDT (European Directive on Tobacco), Michal Dobrajc focused on the transpositions of the Directive in the United Kingdom, France and Germany and on the differences it created between countries. For example, in the United Kingdom, the limit of 2 ml on tanks is considered to apply to all tanks, while in France and Germany it applies only to disposable cartridges containing nicotine. . Similarly, the United Kingdom and France have not listed any additional "prohibited ingredients", while Germany has created a long list, so that a legal e-liquid in the UK and France could easily become illegal in Germany.
« Beliefs and Practices: New Evidence on the Real Use of the Electronic Cigarette », the key points:
- Collaboration between health professionals and the vaping industry could help fight smoking
- Evidence continues to emerge showing the effectiveness of vaping to quit smoking
- Assertions about "particles" in steam are useless and betray ignorance about the daily sources of airborne particles
- US NYTS data do not support the reported outbreak, and vaporizer use rates could largely be explained by marijuana spraying.
At this conference, Emma ward presented the results of his interviews with vapers about the potential for collaboration between vape shops and healthcare professionals in the UK. The research covers several possible methods for creating this partnership, ranging from basic store-based information to items such as promotion schemes, smoking cessation training for store staff and cash payment programs. 'act' for the staff. Most respondents were generally in favor of the partnership explaining that it would reassure people about the potential health risks of vaping products and that this could help make e-cigarettes more affordable. While others felt that vaping should remain a personal choice, or even that it was "unethical" to fund vaping devices.
The research presented by the Dr. Christopher Russell, A psychologist and tobacco reduction researcher focused on the Juul e-cigarette, with a large sample of over 15 000 vapers that used the product for six months. The results showed that 20,3% of participants remained non-smokers three months and even six months after the start of the study.
The study of Karolein Adriaens was smaller, but the results were consistent with those of the Dr. Russell study. In particular, he examined the impact of the addition of vaping products in the standard anti-tobacco treatment offered by the Tobacco Consultants in Belgium. The results showed that vapers were more likely to quit smoking at the end of the study than people using NRT, and that vaping also seemed to reduce the risk of relapse.
Sarah Gentry also spoke about his investigation with a one-year follow-up that focused on the impact of different choices on device and nicotine level on the risk of relapse to smoking. It was found that vapers using batteries and atomizers or clearomizers were less likely to start smoking than cigalikes users, and higher nicotine levels also lowered relapse.
Roberto Sussman gave a unique and energetic speech that highlighted concerns about passive vaping. According to him things are very clear: » If important interventions were needed to protect the public from the submicron particles of the e-cigarette, we would also need even more important interventions for protection against candles, barbecues and even vacuum cleaners.".
#GFN19 Very entertaining talk from Roberto Sussman. Compared vaping emissions to other sources
"If harsh interventions are needed to protect the public from e-cigs micron particles, we need even harsh interventions to protect them from candles, grilling meat and vacuuming" pic.twitter.com/Ciwj96ysya
- Lee Johnson (@JackLebeau) June 14, 2019
Konstantinos Farsalinos closed the session with a rational look at data from US youth smoking surveys conducted in 2017 and 2018, which showed that there was ample evidence of an "epidemic". But as soon as the data is examined in more detail, this interpretation begins to crumble. He decomposed the data into infrequent or frequent use and although usage at all frequencies increased, the vast majority of e-cigarette users used it little or nothing. The most interesting result, however, concerns the issue of the vaporization of cannabis. The NYTS results show that 60% of frequent vapers who have never smoked have already used marijuana with a personal vaporizer. Is the epidemic due to cannabis use?
There was also talk of transparency in the funding of studies. According to Clive Bates: " The funding problem has been treated as a weapon. It is simply a question of suppressing the results that tobacco control does not like. Unfortunately, and with great precision, he points out that "virtuous" funders who could support crucial work simply do not find the issue appealing. There is not much sympathy for smokers ". For the Pr David Abrams everyone is biased! People with "clean" money can also distort science. The only important thing should be the integrity of the scientific data and not who pays the bill.
3EME DAY: SCIENCE ON TOBACCO "NO SMOKING" AND POOR SCIENCE ON THE VAPE
At the 3th day, many topics were discussed, including smoking among homeless people and minority communities such as Maori in New Zealand. But we will deal here with the next subject, ie "Junk Science" or Bad science about vaping.
The different key points of the conference « The scourge of bad science around vaping "
- The bad science about vaping is ubiquitous, but can be refuted by tackling repeated mistakes.
- There is ample evidence that heated tobacco has tremendous potential for reducing smoking-related harm.
- The use of nicotine during pregnancy is not without risk but it is possible to reduce them immediately.
- Passive steam releases fewer particles than tobacco, but it varies by device type
Le Professor Riccardo Polosa addressed the issue of bad science around vaping, but with an optimistic message that " it could be effectively corrected". He pointed out that the same mistakes are repeated over and over again. For example, cell studies ("in vitro" research) are frequently performed using unrealistic vaping protocols and without realistic dosage considerations. In animal research, the problem is similar: for example, mice, despite their tiny weight, often receive nicotine doses similar to those of a human. The fact that these mistakes are repeated brings to light a solution: refute recurring problems and you can eliminate tons of bad research in one place.
Brad Rodu, Professor of Medicine and Risk Reduction Specialist at the University of Louisville gave a comprehensive overview of evidence about the risks of "smokeless" tobacco. In summary, although dry snuff appears to carry risks (although less important than something as common as driving a car), snus and heated tobacco are indeed safe, with the only detectable risks history of smoking. According to him, heated tobacco has enormous potential to reduce tobacco-related illnesses and deaths.
here's @BradRodu summarizing the evidence on smokeless tobacco.
This graph is great - the top cluster is the mortality risk for smokers, the middle is smokers who switched, and is exclusive to smokeless users.
- Lee Johnson (@JackLebeau) June 15, 2019
Marewa Glower, professor specializing in smoking cessation also made an intervention on the use of nicotine during pregnancy. She has reviewed 22 studies in detail, but the general conclusions remain that prematurity is probably related to nicotine use without there being other forms of risk. According to her, this opens up a huge potential to prevent risks.
- AddictionResearchUEA (@AddictionUea) June 15, 2019
Maciej Goniewicz for its part has processed evidence concerning passive vaping. The focus was on particles but overall, research shows that vaping products are better than smoking, even though there is a seemingly pointless focus on "particles" without reference to their specific composition.
source : Ecigarettedirect.co.uk