Scheer Report - Was steckt dahinter Teil 8

Hallo Liebe Leser,

Heute kommt der achte Teil der Anmerkungen zum Scheer Report. Also die Dinge die mir zum Scheer Report aufgefallen ist und welche man als Anregung für eine Mail an die Abgeordneten mitnehmen kann.

Vorab liste ich Euch wie schon im vorigen Teil alle Artikel dieser Serie auf:

Mittlerweile befinden wir uns auf Seite 8 des Scheer Reportes. Ich habe mich beim weiteren durcharbeiten dieses Report dazu entschieden nur noch dann auf bereits erwähnte Aspekte einzugehen, wenn sich neue Argumente finden lassen.

Some data available from the US indicate that the prevalence of electronic cigarette use is increasing in children and adolescents. Health effects of electronic cigarette use in this population are mainly due to nicotine, but are also associated with the particular flavour ingredients (including menthol) and which are most often preferred by this population group.

Overall, the SCHEER is of the opinion that there is strong evidence that electronic cigarettes are a gateway to smoking for young people. There is also strong evidence that nicotine in e-liquids is implicated in the development of addiction and that flavours have a relevant contribution for attractiveness of use of electronic cigarette and initiation.

3. In the EU, research has indicated that from current and former smokers, the number of those who had ever attempted to quit without assistance increased from 70.3% in 2012 to 74.8% in 2017. During this timeframe, experimentation with the use of electronic cigarettes for smoking cessation increased (3.7% to 9.7%), while on the contrary the use of pharmacotherapy (14.6% to 11.1%) and smoking cessation services (7.5% to 5.0%) declined across the EU. Notably, the differences in cessation methods across European Member states were associated with the existence of comprehensive national smoking cessation policies. Recent data on quitting activity, including quit attempts, intention to quit, and use of cessation assistance among a cohort of smokers from eight European countries, indicated that experimentation with electronic cigarettes as a smoking cessation device in the last quit attempt differed substantially across different European Member states, ranging from 5% in Spain to 51.6% in England – highlighting the differences across the EU.

From recent reviews, there is evidence that electronic cigarettes help smokers to stop smoking in the long term compared with placebo electronic cigarettes. However, the small number of trials, low event rates and wide confidence intervals around the estimates result in weak evidence by GRADE standards regarding the support of electronic cigarettes' effectiveness in helping smokers to quit while the evidence on smoking reduction is assessed as weak to moderate.

Based on laboratory simulation, a 10-puff session would result in 2.5–72.5 mg e-liquid inhaled, with 37–69% of aerosol being < 4 μm in size (highly respirable). For e-liquid containing 20 mg/mL nicotine, this would be an intake of 0.08–1.45 mg nicotine/session.

There is strong evidence that exposure to nicotine from electronic cigarettes is highly variable and depends on product characteristics as well as individual smoking habits; there is substantial evidence that nicotine intake from electronic cigarette devices among experienced adult electronic cigarette users can be comparable to that from combustible tobacco cigarettes.

Individuals may be second-hand exposed to exhaled air following a puff. The compounds identified in exhaled air of electronic cigarette users include particulate matter, nicotine, 30 glycerol, propylene glycol, formaldehyde and acetaldehyde, volatile organic compounds 31 (VOCs), metals and, in rare case, polycyclic aromatic hydrocarbons (PAH). The reported 32 concentrations are orders of magnitude lower for all these substances than those reported 33 for exposure of electronic cigarette users. Data on second-hand exposure are however 34 scarce, reported in different units and related to highly different exposure scenarios, device 35 designs, topography, and liquid compositions. The consistency of the data therefore is 36 judged to be low. The weight of evidence for second-hand exposure assessment is judged 37 to be weak to moderate. The highest uncertainty is related to the comparison of 38 concentrations in indoor air due to the highly different exposure scenarios and the scarcity 39 of data.

The health impacts of electronic cigarette’s use are still difficult to establish due to the lack 5 of long-term data from epidemiological studies or clinical trials. However, since 2016, the 6 World Health Organization (WHO)6 has already noted that, while electronic cigarettes might 7 be “less harmful” than conventional cigarettes, electronic cigarettes still “are harmful to 8 health and are not safe”.https://www.who.int/fctc/cop/cop7/FCTC_COP_7_11_EN.pdf

SCHEER Preliminary Opinion on electronic cigarettes
Risk assessment and overall weight of evidence
The daily exposure to aerosol from an electronic cigarette is a compilation of multiple peak exposures with irregular time intervals, and starting from the same total inhaled daily dose it is hardly comparable with exposure scenarios for the general population (continuous exposure of 24 hours per day). Because the available hazard information, often based on animal experiments, will mostly be obtained with an exposure regimen that also will significantly differ from the electronic cigarette use scenario, a direct comparison of exposure and hazard characteristics will generally not be correct and affected by a high degree of uncertainty. As a consequence risks could not be properly assessed based on health based guidance values (HBGVs), which are not suitable to cover peak air concentrations reached during a puff (around two orders of magnitude higher than the inhaled concentration of the general population), followed by non-exposures between electronic cigarette smoking sessions. As a pragmatic alternative, the Margin of Exposure (MoE) approach may be applied with minimal factor of 100 required for non-carcinogenic effects.
2. Role of electronic cigarettes as a gateway to smoking/the initiation of smoking, particularly for young people
Electronic cigarettes are rapidly becoming a new trend among adolescents and the number of users increased from 7.2% in 2012, to 11.6% in 2014 to 14.6% in 2017 in the EU. According to the "Special Eurobarometer 458" from May 2017, 15% of the respondents have at least tried electronic cigarettes and 2% use them regularly. Among young people (15-24 years), ever use is higher than average (25%), a substantially higher rate than experimentation in other age categories. This difference in experimentation was 8.23 times higher in the 15-24 year-old group when compared to those 55 and older, but also was substantially higher than reported ever use among other age groups. Notably, among the 15-24 year-olds who were ever users of electronic cigarettes, 16.9% transitioned to regular 38 users, however the rate of transition between experimentation and regular use was higher in other age groups.

A more recent review on the prevalence of electronic cigarette use among the general adult and young populations in Europe concluded that the prevalence of current electronic cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. It also showed a higher prevalence of electronic cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and 46 former smokers. In 2014, across the European Member states having ever used electronic cigarettes was 5.75 times more likely among 18-24 year olds compared to those >55 years of age, however, adolescents were less likely to be regular user than those aged ≥55 years 49 (16.9% vs. 38.1%).

Ab hier fangen wieder meine Schlussfolgerungen an, welche sich auf die von mir oben zitierten Passagen beziehen.

Some data available from the US indicate that the prevalence of electronic cigarette use is increasing in children and adolescents. Health effects of electronic cigarette use in this population are mainly due to nicotine, but are also associated with the particular flavour ingredients (including menthol) and which are most often preferred by this population group.

Overall, the SCHEER is of the opinion that there is strong evidence that electronic cigarettes are a gateway to smoking for young people. There is also strong evidence that nicotine in e-liquids is implicated in the development of addiction and that flavours have a relevant contribution for attractiveness of use of electronic cigarette and initiation.

The health impacts of electronic cigarette’s use are still difficult to establish due to the lack 5 of long-term data from epidemiological studies or clinical trials. However, since 2016, the 6 World Health Organization (WHO)6 has already noted that, while electronic cigarettes might 7 be “less harmful” than conventional cigarettes, electronic cigarettes still “are harmful to 8 health and are not safe”.https://www.who.int/fctc/cop/cop7/FCTC_COP_7_11_EN.pdf

Okay diesen ganzen Block kann man mit einer einzigen Gegenfrage abhaken, wie erklärt sich die Scheer Kommission den Umstand das es in England nicht mehr Nikotinkonsumenten gibt. Das die Anzahl der Minderjährigen die Dampfen nicht signifikant angegestiegen ist. Sorry? Lest ihr die Statistiken und die Studien innerhalb der EU überhaupt oder greift ihr lieber auf Studien aus anderen Märkten die nicht relevant sind zurück. Ich verweise hier lieber auf die Studien aus England, welche ich in den Quellen unten verlinke.)15)16

Risk assessment and overall weight of evidence
The daily exposure to aerosol from an electronic cigarette is a compilation of multiple peak exposures with irregular time intervals, and starting from the same total inhaled daily dose it is hardly comparable with exposure scenarios for the general population (continuous exposure of 24 hours per day). Because the available hazard information, often based on animal experiments, will mostly be obtained with an exposure regimen that also will significantly differ from the electronic cigarette use scenario, a direct comparison of exposure and hazard characteristics will generally not be correct and affected by a high degree of uncertainty. As a consequence risks could not be properly assessed based on health based guidance values (HBGVs), which are not suitable to cover peak air concentrations reached during a puff (around two orders of magnitude higher than the inhaled concentration of the general population), followed by non-exposures between electronic cigarette smoking sessions. As a pragmatic alternative, the Margin of Exposure (MoE) approach may be applied with minimal factor of 100 required for non-carcinogenic effects.

Natürlich ist die Menge an Nikotin, welche ein DL-Verdampfer abgibt unterschiedlich zu denen die ein MTL-Verdampfer abgibt. Denn die Geräte liefern je nach Dampfweise unterschiedliche Mengen von Dampf ab. 6% MTL ist "normal bis wenig" 6% DL ist "kaum dampfbar" zumindest für die meissten DL-Dampfer. Und das Menschen keine Labormäuse sind, sollte jedem klar sein, der sich beide Spezien mal mit bloßem Auge ansieht.

2. Role of electronic cigarettes as a gateway to smoking/the initiation of smoking, particularly for young people

Electronic cigarettes are rapidly becoming a new trend among adolescents and the number of users increased from 7.2% in 2012, to 11.6% in 2014 to 14.6% in 2017 in the EU. According to the "Special Eurobarometer 458" from May 2017, 15% of the respondents have at least tried electronic cigarettes and 2% use them regularly. Among young people (15-24 years), ever use is higher than average (25%), a substantially higher rate than experimentation in other age categories. This difference in experimentation was 8.23 times higher in the 15-24 year-old group when compared to those 55 and older, but also was substantially higher than reported ever use among other age groups. Notably, among the 15-24 year-olds who were ever users of electronic cigarettes, 16.9% transitioned to regular 38 users, however the rate of transition between experimentation and regular use was higher in other age groups.

A more recent review on the prevalence of electronic cigarette use among the general adult and young populations in Europe concluded that the prevalence of current electronic cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. It also showed a higher prevalence of electronic cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and 46 former smokers. In 2014, across the European Member states having ever used electronic cigarettes was 5.75 times more likely among 18-24 year olds compared to those >55 years of age, however, adolescents were less likely to be regular user than those aged ≥55 years 49 (16.9% vs. 38.1%).

Hier fällt mir nur ein das die sogenannten Sensation Seeker irgendwie in deren Logik nicht auftauchen. Warum wird so etwas nicht einkalkuliert? Gerade in der Pubertät ist es doch normal neues auszuprobieren. Dabei auch Risiken ein zu gehen. Wie tauchen die denn auf? Und ein viel grundlegenderes Problem- Seit wann dürfen Jugendliche E-Zigaretten erwerben? WTF!!! Zumindest in Deutschland wird der Erwerb von Tabakerzeugnissen zu denen auch die E-Zigarette leider gehört über das Jugendschutzgesetz geregelt.

Fazit

Ja was soll ich hier noch groß schreiben? Habe ich etwas anderes erwarten nach den bisherigen Arbeiten zu dieser Artikelserie? Nein! Worauf es rauslaufen wird hab ich auch schon lang und breit in mehreren Artikeln ausgeführt. Liebe Leser es liegt an Euch etwas zu ändern. Tut es, oder lasst es bleiben.

in diesem Sinne

Seid Achtsam