Health New Zealand News 2010             for more items see www.endsmoking.nz/2010.htm

 

2 July 2010

Health New Zealand Ltd asks Inquiry for tobacco firms to report Nicotine content of all brands of smoking tobacco products View submission

 

to enable smokers to taper their nicotine intake properly, and to pave way for taxation of nicotine content and for the lowering of addictiveness of cigarettes.

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17 June 2010

Research: Major electronic cigarette trial – funded- world first

Health Research Council of NZ announced this week (www.hrc.govt.nz) the award of a grant to Clinical Trials Research Unit University of Auckland, for a randomized controlled trial of electronic cigarettes as a smoking cessation device. The principal investigator is Associate Professor Chris Bullen, and co-investigators are Drs Natalie Walker, Hayden McRobbie and Murray Laugesen. To our knowledge this is the first randomized controlled trial in any country of the electronic cigarette for smoking cessation to be funded. The trial will compare a nicotine electronic cigarette with a nicotine patch and with a zero-nicotine electronic cigarette. This trial will provide some clinical evidence with respect to safety.

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13 June 2010

Interview: The Last Gasp

Anthony Hubbard Sunday Star Times p.C5

Anti-smoking groups are pushing for a ban on cigarette sales – but critics say it would just lead to a huge blackmarket.

Interview with Dr Murray Laugesen www.endsmoking.org.nz/News2010.htm

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11 June 2010

Research: Pre-cessation nicotine replacement therapy: pragmatic randomized trial: published

Chris Bullen, Colin Howe, Ruey-Bin Lin, Michele Grigg, Murray Laugesen,

Hayden McRobbie, Marewa Glover, Natalie Walker, Mark Wallace-Bell,

Robyn Whittaker & Anthony Rodgers. Addiction doi:10.1111/j.1360-0443.2010.02989.x

Conclusions In this, the largest pre-cessation NRT trial to date, using NRT 2 weeks before the target quit day was safe and well tolerated but offered no benefit over usual care. However, in conjunction with previous pre-cessation trials there appears to be a moderate benefit, but not as large as that seen in most smaller trials.

  

 

1 June 2010  

Research: Zonnic nicotine mouth spray and lozenge effective in relieving cravings: published

McRobbie H, Thornley S, Bullen C, Lin R-B, Senior H, Laugesen M, Whittaker R, Hayek P. A randomized trial of the effects of two novel nicotine replacement therapies on tobacco withdrawal symptoms and user satisfaction.

Published in Addiction On line 14 May 2010 ahead of print.  Abstract at www.pubmed.org  PMID 20491724

 

Comment Despite having researched these nicotine products in NZ, NZ’s small market does not get priority for early sale here. 

The Zonnic mouthspray, on sale in Sweden, is being trialled (recruiting now) during 2010 in Christchurch and Wellington by University of Otago (Prof Julian Crane and Dr Caldwell brent.caldwell@otago.ac.nz ), for its ability to help people stop smoking. 

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17 May 2010

Pulmonary delivery of Nicotine Pyruvate: Pharmacokinetic and Sensory Characteristics

In Experimental & Clinical Psychopharmacology journal: For publication soon: Accepted

Jed E. Rose, James E. Turner, Thangaraju Murugesan, Frederique M. Behm, and Murray Laugesen

An advance on the e-cigarette, in that  nicotine is absorbed rapidly via the lung..  See below under March 2010 for more information.

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14 May 2010

Oral submission to the Maori Affairs Select Committee Inquiry into the Tobacco Industry

from Health New Zealand Ltd: Summarises company research relevant to the Inquiry. (Powerpoint slideshow). more....        

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14 May 2010

Four policies to end sales of cigarettes and smoking tobacco in New Zealand by 2020:published

NZ Medical Journal 14 May 2010. http://www.endsmoking.org.nz/FourPolicies14May2010.pdf

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17 April 2010 NZ Herald

Medical rules lead to withdrawal of electronic quit-smoking aid

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10638910  An online pharmacy recalls nicotine ecigarettes

 

15 April 2010 NZ Herald

Smoker wants e-ciggie nicotine in a shop near him

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10638418  An ecigarette fan was once a very heavy smoker.

 

Newswire 13 April 2009

Health campaigner: The e-ciggie a step towards ending nicotine’s evil

Virginia McMillan. Interview with Dr Murray Laugesen: 25 years working on smoking, 50 years in medicine.

http://www.newswire.co.nz/2010/04/health-campaigner-e-ciggies-a-step-towards-ending-nicotines-evil/

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NZ Herald 13 April 2009

E-ciggie may help smokers to quit

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10638017

NZ E-cigarette trial Tob Control 2010;19:98-103 doi:10.1136/tc.2009.031567   published 9 April 2009

The electronic cigarette is effective in raising plasma nicotine levels, and in reducing cravings, and is more pleasant to use than the medicinal nicotine inhaler…………….

  Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial

 C Bullen1, H McRobbie2, S Thornley3, M Glover4, R Lin5, M Laugesen6      Full text as pdf

Abstract

Objectives To measure the short-term effects of an electronic nicotine delivery device (“e cigarette”, ENDD) on desire to smoke, withdrawal symptoms, acceptability, pharmacokinetic properties and adverse effects.

Design Single blind randomised repeated measures cross-over trial of the Ruyan V8 ENDD.

Setting University research centre in Auckland, New Zealand.

Participants 40 adult dependent smokers of 10 or more cigarettes per day.

Interventions Participants were randomised to use ENDDs containing 16 mg nicotine or 0 mg capsules, Nicorette nicotine inhalator or their usual cigarette on each of four study days 3 days apart, with overnight smoking abstinence before use of each product.

Main outcome measures The primary outcome was change in desire to smoke, measured as “area under the curve” on an 11-point visual analogue scale before and at intervals over 1 h of use. Secondary outcomes included withdrawal symptoms, acceptability and adverse events. In nine participants, serum nicotine levels were also measured.

Results Over 60 min, participants using 16 mg ENDD recorded 0.82 units less desire to smoke than the placebo ENDD (p=0.006). No difference in desire to smoke was found between 16 mg ENDD and inhalator. ENDDs were more pleasant to use than inhalator (p=0.016) and produced less irritation of mouth and throat (p<0.001). On average, the ENDD increased serum nicotine to a peak of 1.3 ng/ml in 19.6 min, the inhalator to 2.1 ng/ml in 32 min and cigarettes to 13.4 ng/ml in 14.3 min.

Conclusions The 16 mg Ruyan V8 ENDD alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette. Evaluation of the ENDD for longer-term safety, potential for long-term use and efficacy as a cessation aid is needed.

The trial was funded by Ruyan the manufacturer, through Health New Zealand Ltd as the NZ sponsor, and carried out by Clinical Trials Research Unit, University of Auckland.. Ruyan, the funder, had no influence on the design, analysis, results or conclusions.

 

Revised 13 April 2010

Critique of WHO Tobacco Regulation Committee report on electronic cigarettes

Health New Zealand Ltd sees potential in e-cigarettes, while WHO group sees them as a threat

TobRegCritique.doc

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1 March 2010

New nicotine cigarette gives rapid lung delivery of nicotine

 

After tests in Christchurch in 2009, this product is now ready for commercialization as a smoking substitute or as a stop smoking medicine 

 

SRNT 2010_ PosterAbstract_ Rose.doc 

This device was tested by Health New Zealand Ltd Christchurch NZ and Christchurch Clinical Studies Trust, for Duke University (the patent holders), in 2009 on nine healthy smokers. Results were announced by Principal Investigator Dr Jed Rose, of Duke University at the 16th Annual Conference of the Society for Research on Nicotine and Tobacco (SRNT), Baltimore, Maryland, USA on 27 February 2010. Turner, a co-inventor of the nicotine inhaler; and Dr Raju Murugesan, a pharmacologist at Duke. Dr Laugesen and Dr Chris Wynne of Christchurch Clinical Studies Trust were co-authors for this paper, entitled  Pulmonary delivery of Nicotine Pyruvate: Pharmacokinetic and Sensory Characteristics

Dr Laugesen and Dr Chris Wynne of Christchurch Clinical Studies Trust were co-authors for this paper, entitled

The inventors are Dr Jed Rose, a neuroscientist at Duke; his brother Dr Seth Rose, an organic chemistry professor; Dr Jim

 

         Pulmonary delivery of Nicotine Pyruvate: Pharmacokinetic and Sensory Characteristics

 

The device depends on a chemical reaction at room temperature, with no heating or lighting up. The nicotine pyruvate cigarette will reach the market in 3 to 5 years time. It is yet to be manufactured and miniaturized down to the size of a tobacco cigarette. It is not an electronic cigarette. The smoker only inhales one molecule – nicotine pyruvate, which dissolves into nicotine and pyruvate on reaching the lungs.

Pyruvate is a normally found in the blood, and inhaling NP is not expected to raise this level appreciably

 

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Nicotine levels will be raised briefly with every puff taken, though not as much as from smoking tobacco cigarettes.  To see the graph click on: News2010_files\image002.gif

Nine healthy smokers took 10 puffs over the first five minutes. When nicotine in plasma was measured by taking blood at the end of the 10th puff, the nicotine level in the plasma for NP 20 and NP 30 (nicotine pyruvate 20 and 30 micrograms per puff)  increased to 5 to 8 ng per ml, a third to a half as high as with a regular tobacco cigarette, and as rapidly.  The NP cigarette was less harsh and much more rapid in raising plasma nicotine. In contrast the NV (Medicinal nicotine inhaler) resulted in a much slower rise to 1 ng/mL after 35 minutes.

 

Maori Affairs Select Committee on the Inquiry into the tobacco industry in Aotearoa and the health consequences of tobacco use for Maori; Health NZ submission

Read the full submission at                      HNZSubmission_MASC_2010.pdf

Published on MASC website February 2010

The submission focuses on

  • The case for phasing out commercial cigarettes by 2020.
  • Findings and conclusions from Health New Zealand’s world leading research

       on cigarettes and nicotine cigarette substitutes.

 

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E-cigarettes need quality safeguards: Letter to British Medical Journal http://www.bmj.com/cgi/eletters/340/jan19_1/c311                        22 January 2010

Murray Laugesen,
public health physician

Health New Zealand Ltd, Christchurch, New Zealand 8082

Flouris and Oikonomou lament the lack of data on e-cigarette risks.[1] Apart from our 2008 poster cited [1], our further reports [2, 3] and extensive emissions data we gathered in 2009 show complete absence of most priority cigarette toxicants in e-cigarette liquid and mist. However, we only tested one brand (Ruyan, Beijing). And, as Flouris and Oikonomou point out, quality safeguards in manufacture are essential.

Even if testing showed all e-brands were less toxic than cigarettes, consumer safety requires quality control at site of manufacture, and monitoring to minimise the risk of adulteration. In 1990, propylene glycol, now used to create the mist in e-cigarettes, was adulterated by toxic diethylene glycol (DEG) with tragic results. As recently as 2007, US FDA found DEG in Chinese toothpaste at 3%,[4] and found DEG at 1% level in 2009 in one e-cigarette brand.[5] E-cigarettes need regulation imposed to safeguard their quality, so they can continue to provide an alternative to cigarette smoking.

Murray Laugesen, Public health physician, Health New Zealand Ltd. www.healthnz.co.nz

1. Flouris AD, Dimitris N Oikonomou DN. Electronic cigarettes: miracle or menace? Letter. BMJ 2010;340:c311

2. Laugesen M. Safety report on Ruyan e-cigarette and cartridge. 30 October 2009. http://www.healthnz.co.nz/RuyanCartridgeReport30-Oct-08.pdf 

3. Laugesen M. Ruyan e-cigarette bench-top tests. Poster. Society for Research on Nicotine and Tobacco. Dublin April 2009. www.healthnz.co.nz/DublinEcigBenchtopHandout.pdf 

4. Throw away Chinese toothpaste, FDA warns. Products may contain poisonous chemical used in antifreeze. Associated Press 1 June 2007. http://www.msnbc.msn.com/id/18985512/ 

5. Westenberger BJ. Evaluation of e-cigarettes. Center for Drug Evaluation and Research, Division of Pharmaceutical Analysis, St Louis, MO. US Food and Drug Administration. 2009.

Competing interests: Research contract with Ruyan during 2008, but no financial interest in Ruyan.

 

© Health New Zealand 2010