Researching safer alternatives to cigarette smoking

Last updated 7 July  2010

R & D plan 2003-2012:  the quest for safer product choices for smokers

Conclusions so far:

Cigarette smoke kills thousands in New Zealand. No deaths due to nicotine have been reported.

In 2006 after research on the Marlboro UltraSmooth cigarette, Laugesen and Fowles concluded that even with the best filters devised, smoking combustible cigarettes is irredeemably dangerous. Reducing cigarette harm is therefore a matter for advocacy to reduce cigarette sales. (see www.endsmoking.org.nz) and to provide safer alternative products:

Health New Zealand Ltd then began to test safer (non-combustible) smoking substitute products. Nasal and oral snuffs attracted little support from smokers or funders.

Dr Laugesen switched to studying nicotine products, first oral products (spray, pouch, lozenge, gum) and how these could be used more effectively (before quitting, by providing more alternatives, by using them alongside denicotinised cigarettes).

Dr Laugesen then studied vapourised nicotine – he was first to test the e-cigarette during 2008, and then with Rose of Duke University in 2009, he tested the nicotine pyruvate cigarette.

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Health New Zealand Ltd’s 2003-2012 R& D plan to promote safer alternatives to cigarette smoking

Name of product

Barrier to increased sale

Manufacturer

Remarks

Next steps, 2008-09-10

Health New Zealand Ltd role

Tobacco Products – combustible

 

 

 

HNZ 1 Firesafe cigarettes

Manufacturers fail to supply market with fire safe cigs.

All cigarette manufacturers

No fire-safe cigarettes on sale: No NZ regulations

NZ Standards in 2009 adopt fire- safe standard

In 2003 in Tobacco Control showed RYOs are firesafe. HNZ in 2009 helps set Standard via Standards Committee.

HNZ2 Marlboro UltraSmooth

Since our research, this MUS brand withdrawn from sale.

Philip Morris USA

No safer than a Holiday regular brand

Project complete.

Published research on this cigarette in 2006 in Tobacco Control. Cigarettes can’t be made safe to an acceptable degree.

Tobacco Products – non-combustibles

HNZ3 Reduced- nicotine cigarettes (RNC)

RNCs not sold commercially in NZ at present

Vector Tobacco Company

Do very low nicotine cigarettes

if used for 6 weeks with NRT, increase success in quitting?

CTRU  recruiting for this RCT in April 2009 through to Oct 2010.

Dr Laugesen a co-investigator in this 3 year study (The RELIQ study)

HNZ4 Swedish Snus

(moist tobacco snuff)

Requires law change to allow sale. Regulations needed to exclude snuffs not in line with Swedish standards.

Swedish Match

 

Can’t be sold in NZ. Can be imported for personal use; cost prohibitive due to tax.

RCT for stop smoking study still needed. Lack of non-tobacco donor.

Co-applicant with Professor Crane, Wellington School of Medicine, to HRC for funds for RCT for stop smoking; Not successful in 2006, 2007, 2008.

HNZ5

Nasal tobacco snuff

Legal to sell, illegal to advertise. No public information on (low) relative harm of snuffs.

Swedish Match

Few repeat sales in 2007-8.  Sales cannot succeed while advertising banned.

No further research worthwhile as sales low.

Health NZ research on nasal snuff  now complete and displayed at www.endsmokng.org.nz

Nicotine-only products – not inhaled

 

 

 

HNZ 6 Nicotine gum, patch, lozenge

Subsidised by government through vouchers.

Pfizer, Novartis

Aims to elucidate benefits of greater choice for quitters.

CTRU RCT is finished recruiting.

Co-investigator wth CTRU team. (the SONIQ study) For publication in 2010.

HNZ 7 Nicotine pouch, spray, lozenge.

Sale in NZ requires registration as a medicine. Market small. NN has not yet applied to sell it in NZ.

Niconovum AB. (NN) Helsingborg, Sweden

On sale in Sweden in 2009. Mouth spray also, and gum.

CTRU with HNZ completed PK study** in 2007. NN later sells out to Reynolds Tobacco Coy.

Co-investigator with CTRU. (The NEWS study). Study now published. McRobbie, 2009, 2010.

.

Nicotine-only products –  inhaled

Electronic cigarette A). HNZ8 PK testing and effect on cravings

_________

B) HNZ 9

Electronic cigarette Benchtop safety tests

Sale in NZ requires approval as a medicine. Sale is permitted in USA and UK as a cigarette alternative.

Ruyan (Holdings) Ltd, Hong Kong and Beijing, China. Funded by manufacturer

(Ruyan)

In 2008, Health NZ Ltd is main tester for Ruyan outside of China. Back-ground paper 2008 for WHO’s Tobacco Regulation Committee.

PK testing finished, 2009. Submitted for publication.

Co-investigator. (the WIRED study) Contract manager for the funder. Published 2010.

Safety testing completed, 2009. Paper submitted.

 Coordinator  and principal investigator

HNZ 10 Nicotine pyruvate inhaler/ cigarette

Not in production. Not registered for sale.

Prototype only

Inventor Dr Jed Rose.

Funded by Duke Univ. North Carolina USA

A novel product tested in 2009.

Managed testing in Christchurch. Co- investigator. To be published in 2010.

HNZ 11

E-cigarette RCT  

Study of efficacy in Smoking cessation

To be decided.

Funded. Health Research Council of NZ

RCT E-cig v.Patch and v. placebo.

2011-2012

Co investigator, CTRU

First such trial of an e-cigarette to be funded.

HNZ 12

2010 for 2011

Further study on e-cigarettes

Funders and collaborators sought

 

 

 

  *RCT = Randomised Controlled Trial. CTRU = Clinical Trials Research Unit, Univ. of Auckland.

# NHF = National Heart Foundation.

**PK study = pharmacokinetic study to show whether blood nicotine increased.

© Health New Zealand Ltd 2010