Re: The potential effects of tobacco control in China: projections from the China SimSmoke simulation model
The use of computer stimulation to predict success of China’s smoking trajectory is of immense importance to anyone interested in curbing the global tobacco epidemic1.
However, one needs to be aware of a new player in the field, namely the advent of electronic cigarettes (EC)2. This intervention is likely to have an appreciable impact on these predictions based on computer simulations. ECs have now begun to spread its tentacles worldwide2. This will skew the distribution of tobacco smoking rates and the predicted adverse health effects in a number of ways.
There is mounting evidence on the role of EC in promoting the tobacco habit in the young or cigarette naïve population, re-normalising cigarette smoking and the potential health impact on passive smoking2,3,4. An observational study of retail availability and in-store marketing of e-cigarettes in London demonstrates how it could ultimately increase tobacco use5. All these are indicative as to how EC could undermine recent victories against tobacco use. However, ECs are also advocated as a method of tobacco cessation and reducing harm from passive smoking, which could be potentially a useful outcome6. Though the ultimate consequences of ECs are not certain-Big tobacco companies seem to have recognized ECs as future allies, and have purchased some of the companies, including the original Chinese company which launched the commercial production of EC7.
We may therefore need further improvements to the model to factor-in the impact of ECs while calling on public health regulators for tougher legislations to curb this new epidemic8. If not, Big Tobacco would decide on the next battle ground for its worldwide campaign of promoting painful deaths on millions more.
1. Levy,H Rodríguez-Buño RL, Hu,T-W, Moran AE. The potential effects of tobacco control in China: projections from the China SimSmoke simulation model BMJ 2014;348:g113 doi:http://dx.doi.org/10.1136/bmj.g1134 (accessed 25 February 2014)
2. The Renormalization of Smoking? E-Cigarettes and the Tobacco “Endgame” Fairchild,AL, Bayer, R, and Colgrove, J. N Engl J Med 2014; 370:293-295.
3. A. D. Flouris and D. N. Oikonomou. Electronic cigarettes: miracle or menace? Br. Med. J. 340, c311; 2010.
4. Schober W1, Szendrei K2, Matzen W2, Osiander-Fuchs H3, Heitmann D4, Schettgen T5, Jörres RA6, Fromme H2.Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health. 2013 Dec 6. pii: S1438-4639(13)00153-3. doi: 10.1016/j.ijheh.2013.11.003. (accessed 25 February 2014)
5. Hsu R, Myers AE, Kurt M Ribisl KM, Marteau TM An observational study of retail availability and in-store marketing of e-cigarettes in London: potential to undermine recent tobacco control gains? BMJ Open 2013;3:e004085 doi:10.1136/bmjopen-2013-004085. (accessed 25 February 2014)
6. Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N. Electronic cigarettes for smoking cessation: a randomised controlled trial
Lancet 2013;382:1629-1637
7. Cressey D. Regulation stacks up for e-cigarettes: Devices may be the ‘healthy’ future of smoking — or a menace? Nature, 2013;501:473.
Rapid Response:
Re: The potential effects of tobacco control in China: projections from the China SimSmoke simulation model
The use of computer stimulation to predict success of China’s smoking trajectory is of immense importance to anyone interested in curbing the global tobacco epidemic1.
However, one needs to be aware of a new player in the field, namely the advent of electronic cigarettes (EC)2. This intervention is likely to have an appreciable impact on these predictions based on computer simulations. ECs have now begun to spread its tentacles worldwide2. This will skew the distribution of tobacco smoking rates and the predicted adverse health effects in a number of ways.
There is mounting evidence on the role of EC in promoting the tobacco habit in the young or cigarette naïve population, re-normalising cigarette smoking and the potential health impact on passive smoking2,3,4. An observational study of retail availability and in-store marketing of e-cigarettes in London demonstrates how it could ultimately increase tobacco use5. All these are indicative as to how EC could undermine recent victories against tobacco use. However, ECs are also advocated as a method of tobacco cessation and reducing harm from passive smoking, which could be potentially a useful outcome6. Though the ultimate consequences of ECs are not certain-Big tobacco companies seem to have recognized ECs as future allies, and have purchased some of the companies, including the original Chinese company which launched the commercial production of EC7.
We may therefore need further improvements to the model to factor-in the impact of ECs while calling on public health regulators for tougher legislations to curb this new epidemic8. If not, Big Tobacco would decide on the next battle ground for its worldwide campaign of promoting painful deaths on millions more.
1. Levy,H Rodríguez-Buño RL, Hu,T-W, Moran AE. The potential effects of tobacco control in China: projections from the China SimSmoke simulation model BMJ 2014;348:g113 doi:http://dx.doi.org/10.1136/bmj.g1134 (accessed 25 February 2014)
2. The Renormalization of Smoking? E-Cigarettes and the Tobacco “Endgame” Fairchild,AL, Bayer, R, and Colgrove, J. N Engl J Med 2014; 370:293-295.
3. A. D. Flouris and D. N. Oikonomou. Electronic cigarettes: miracle or menace? Br. Med. J. 340, c311; 2010.
4. Schober W1, Szendrei K2, Matzen W2, Osiander-Fuchs H3, Heitmann D4, Schettgen T5, Jörres RA6, Fromme H2.Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health. 2013 Dec 6. pii: S1438-4639(13)00153-3. doi: 10.1016/j.ijheh.2013.11.003. (accessed 25 February 2014)
5. Hsu R, Myers AE, Kurt M Ribisl KM, Marteau TM An observational study of retail availability and in-store marketing of e-cigarettes in London: potential to undermine recent tobacco control gains? BMJ Open 2013;3:e004085 doi:10.1136/bmjopen-2013-004085. (accessed 25 February 2014)
6. Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N. Electronic cigarettes for smoking cessation: a randomised controlled trial
Lancet 2013;382:1629-1637
7. Cressey D. Regulation stacks up for e-cigarettes: Devices may be the ‘healthy’ future of smoking — or a menace? Nature, 2013;501:473.
8. http://www.bloomberg.com/news/2013-09-02/imperial-tobacco-agrees-to-acqu... (accessed 25 February 2014)
Competing interests: No competing interests