South Koreas fight against smoking has had some success.
In 1998, when the first nationwide survey of smoking prevalence was conducted in the country, more than 35 out of every 100 Korean adults were smokers. Now, it is just about 19.
A closer look at the data, however, reveals some disturbing trends: e-cigarettes and unconventional tobacco products are gaining a strong foothold here, on top of growing tobacco use among youth and women.
The countrys latest anti-smoking campaign, unveiled on May 31, shows where the battle line is being drawn in its tobacco control policy. The campaigns catchphrase states there is no such thing as safer cigarettes.
The problem is that the authorities and regulations are straggling behind the evolving alternative tobacco industry. In fact, some new products are not even classified as tobacco products by local law, meaning they are not subject to strict tobacco-related rules and regulations.
A member of the Korea Vegan Union cuts cigarettes and sausages as part of a demonstration urging people to quit smoking and go vegan in this May 31 file photo. (Yonhap)
The legal status of e-cigarettes and HTPs in the country has also been ambiguous, to say the least. According to the Tobacco Business Act, some are technically not even legally classified as cigarettes.
The act defines tobacco as a product using tobacco leaves as all or any part of the raw materials for the purpose of chewing, smelling, smoking, sucking, or inhaling. The key term here is tobacco leaves, which means cigarettes made using other parts of the tobacco plant -- such as the stem or root -- or synthesized nicotine cannot be regulated by this act.
This is in line with the WHO Framework Convention on Tobacco Control, the international treaty ratified by 180 countries across the world, which also defines tobacco products as those made using leaf tobacco.
Most tobacco products in the country use nicotine extracted from tobacco leaves, falling under the legal category of tobacco, but there are some that use nicotine extracted from other parts of the tobacco plant.
Lawmakers and activists in the country have been calling for a revision of the law to incorporate ingredients extracted from all parts of the tobacco plant, not just the tobacco leaf.
In 2019, then-lawmaker Kim Seung-hee -- currently the welfare minister nominee of President Yoon Suk-yeol -- proposed such a revision, which fell through without discussion due to the COVID-19 pandemic demanding all lawmakers and policy makers attentions. A similar law revision is currently pending at the National Assembly.
Lee Sung-kyu, the head of the Korea Center for Tobacco Control Research & Education, said it is necessary to expand the definition for both the WHO FCTC and the countrys law.
A legal blind spot is one thing, but there is essentially no way to regulate new tobacco products from entering the Korean market, he said.
Another issue related to regulation is one concerning material added for flavoring, which is widely used in e-cigarettes in particular.
In the US, youth vaping has been described as an epidemic, as thousands of kid-friendly flavors have fueled the popularity of e-cigarettes among young people.
The country in 2009 passed the Family Smoking Prevention and Tobacco Control Act to ban cigarettes with flavors other than menthol or tobacco, and other countries including Canada, Brazil and several nations in the European Union have imposed bans on varying levels.
South Korea currently has no regulation on flavored tobacco, and its sales have increased from 270 million packs in 2011 to 1.38 billion in 2020, while the overall sales of cigarettes fell from 4.4 billion to 3.59 billion in the same period.
The only legal restriction related to flavor additives is Article 9-3 of the National Health Promotion Act, which stipulates that any flavoring added to tobacco shall not be indicated via words, pictures or photographs on the products packaging or advertisements.
How harmful are they?
Nearly two decades since the modern concept of electronic cigarettes was first introduced by a Chinese pharmacist, a question that has lingered on everyones minds is how much of a health risk e-cigarettes pose compared to regular cigarettes.
In January 2018, the US National Academies of Science, Engineering and Medicine released a consensus report on 800 different studies and concluded that e-cigarettes both contain and emit a number of potentially toxic substances.
A man uses an e-cigarette. (123rf)
While not many would say aerosols from either e-cigarettes or HTPs are harmless, researchers are split on how harmful they can be to humans.
Philip Morris Korea, one of the leaders in the South Korean HTP market, has maintained that aerosols from its products contain significantly less harmful chemicals compared to regular cigarettes.
The US Food and Drug Administration in March authorized a reduced exposure claim for the companys Iqos 3 system holder and charger, allowing it to market the product in the US with the following exposure information: The Iqos system heats tobacco but does not burn it This significantly reduces the production of harmful and potentially harmful chemicals Scientific studies have shown that switching completely from conventional cigarettes to the Iqos system significantly reduces your bodys exposure to harmful or potentially harmful chemicals. The FDA stresses that the authorization does not imply that the product is safe or FDA-approved.
But interpretations of this vary. Following Philip Morris Internationals initial application in 2016, researchers from the department of clinical pharmacology at the University of California, San Francisco looked into it and found that the company reported levels for only 40 out of 93 harmful and potentially harmful constituents on the FDAs Harmful and Potentially Harmful Constituents (HPHCs) list in the Iqos mainstream aerosol.
(Philip Morris Internationals) data appear to support PMIs claim that Iqos reduces exposure to HPHCs. However, PMIs data also show significantly higher levels of several substances that are not recognized as HPHCs by the FDA in Iqos emissions compared with combustible cigarette smoke, the researchers concluded in the study.
In a 2020 report, Doctor Cho Hong-jun of the department of Family Medicine at Asan Medical Center pointed out that the initial reports by PMI does not disclose exact levels of hazardous substances that could be in the HTPs, and not combustible (regular) cigarettes. This indicates that HTPs could potentially cause illnesses other than those caused by combustible cigarettes, he wrote.
Cho went on to say that lower levels of HPHCs in e-cigarettes and HTPs as defined by the FDA cannot be directly translated into health benefits compared to regular cigarettes. This is because the relationship between exposure and effects is non-linear for cardiovascular diseases, he said. The duration of exposure is more important than the level of exposure in determining lung cancer mortality, he added.
Hence, tobacco control measures should be the same for e-cigarettes, HTPs, and combustible cigarettes, he concluded.
KT&G -- the leading tobacco company in the country which recently claimed the top spot in the HTP market -- has refrained from publicly commenting on this issue in the past. However, it recently switched its position. HTPs are an alternative product (to cigarettes), and we (KT&G) believe they should be subject to different regulations than those for cigarettes, the company told The Korea Herald.
Besides the vapors, another possible health risk lies in the device itself.
Before the world was taken over by COVID-19, there had been an outbreak of e-cigarette or vaping use-associated lung injury, or EVALI, between mid-2019 and early-2020. Vitamin E acetate -- an additive in some THC-containing e-cigarettes -- is a strong culprit of illnesses, but other chemicals had not been ruled out.
The patients, almost exclusively Americans, were found to have been using unregulated cannabis vaping products.
Some countries like Canada regulate vaping devices under the Canada Consumer Product Safety Act, but that is not the case for South Korea. Under the current law, devices for e-cigarettes are not categorized as tobacco products, and cannot be regulated under the Tobacco Business Act.
More effort needed
There have been calls for a comprehensive effort on the governments part to handle the issue of e-cigarettes and HTPs. Also, there have been calls to uncover exactly what their effects are on health and how much they should be regulated. The South Korean government had launched a pan-government taskforce on the health risks of e-cigarettes and HTPs on the coattails of the EVALI outbreak, but its activities were limited by the ensuing COVID-19 pandemic.
Since issues related to cigarettes extend across multiple sectors of society, such as public health, industry and law, the Korea Center for Tobacco Control Research & Educations head Lee said that a pan-government effort is necessary to tackle this problem. He also stressed that raising public awareness on potential health hazards of e-cigarettes is crucial.
Lack of awareness is a huge problem. Even many experts are unaware of this law (in the Youth Protection Act), and so many misperceptions are spread across society. It is dangerous that many people think e-cigarettes are not harmful, Lee said.
By Yoon Min-sik (minsikyoon@heraldcorp.com)
See the original post here:
[Newsmaker] Should e-cigarettes be subject to more regulation? - The Korea Herald
- Cardiology and Cardiac Pharmacology [Last Updated On: April 4th, 2018] [Originally Added On: April 4th, 2018]
- EMS Pharmacology: Drugs That Affect the Cardiovascular System ... [Last Updated On: April 8th, 2018] [Originally Added On: April 8th, 2018]
- EMS Pharmacology: Drugs That Affect the Cardiovascular ... [Last Updated On: April 11th, 2018] [Originally Added On: April 11th, 2018]
- Cardiology Conferences - Cardiology and Cardiovascular ... [Last Updated On: June 5th, 2018] [Originally Added On: June 5th, 2018]
- Cardiovascular Pharmacology: Open Access - Open Access ... [Last Updated On: June 21st, 2018] [Originally Added On: June 21st, 2018]
- CV Pharmacology | Welcome to Cardiovascular Pharmacology ... [Last Updated On: July 31st, 2018] [Originally Added On: July 31st, 2018]
- Cardiology Conferences | Cardiac pharmacology 2018 ... [Last Updated On: September 13th, 2018] [Originally Added On: September 13th, 2018]
- Cardiology Conference | Cardiac Pharmacology 2019 ... [Last Updated On: November 18th, 2018] [Originally Added On: November 18th, 2018]
- Cardiovascular Pharmacology Online Course | Lecturio [Last Updated On: November 30th, 2018] [Originally Added On: November 30th, 2018]
- Cardiovascular Pharmacology: Open Access [Last Updated On: December 16th, 2018] [Originally Added On: December 16th, 2018]
- Cardiovascular In vivo Models for Drug Discovery [Last Updated On: December 21st, 2018] [Originally Added On: December 21st, 2018]
- UTHSC College of Medicine: Department of Pharmacology [Last Updated On: February 2nd, 2019] [Originally Added On: February 2nd, 2019]
- Department of Pharmacology - School of Medicine - LSU ... [Last Updated On: April 5th, 2019] [Originally Added On: April 5th, 2019]
- Cardiovascular Pharmacology: Open Access - longdom.org [Last Updated On: April 22nd, 2019] [Originally Added On: April 22nd, 2019]
- ASPET | Cardiovascular Pharmacology [Last Updated On: September 14th, 2019] [Originally Added On: September 14th, 2019]
- Pharmacogenomics Market (PGx) Competitive Research And Precise Outlook 2019 To 2025: Astrazeneca, GeneDX, Illumina, Inc., Laboratory Corporation of... [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Global and Chinese Microbiome Drugs Market: Industry strategic plan for the period 2019-2024 - Market Report Gazette [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Pharmacokinetics Market To Increase at Steady Growth Rate - Commerce Gazette [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Moderna Announces Positive Phase 1 Results for the First Systemic Messenger RNA Therapeutic Encoding a Secreted Protein (mRNA-1944) - BioSpace [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Janssen to Highlight Depth of Prostate Cancer and Solid Tumor Portfolios with Multiple Data Presentations at ESMO 2019 - Yahoo Finance [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Cardiac fibrosis study identifies key proteins that translate into heart disease - BSA bureau [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Nitric Oxide: Worldwide Therapeutics & Markets to 2028 with Profiles on 35 Companies & 18 Collaborations Tabulated - Yahoo Finance [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Cytokinetics Announces Data From Phase 1 Study of CK-3773274 at the HFSA 23 Annual Scientific Meeting - Yahoo Finance [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Is it risky to continue with blood thinner drugs after a gastrointestinal bleed? - Medical News Bulletin [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Women urged to exercise and eat well due to cholesterol after menopause - Sydney Morning Herald [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Former Executive Director of Preclinical Safety at Novartis, Klaus Peter Hoffmann, MD, PhD, Joins NDA Partners as Expert - Yahoo Finance [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Yale alumna Dr. Nancy Brown named dean of Yale School of Medicine - Yale News [Last Updated On: September 18th, 2019] [Originally Added On: September 18th, 2019]
- Verve Therapeutics Appoints Cardiologist Andrew Bellinger, M.D., Ph.D., as Chief Scientific Officer - Business Wire [Last Updated On: October 7th, 2019] [Originally Added On: October 7th, 2019]
- G-Protein Coupled Receptors (GPCRs) Market Size And Prediction By Leading Manufacturers According To Its Application And Types Till 2022 - Space... [Last Updated On: October 7th, 2019] [Originally Added On: October 7th, 2019]
- Best supplements for blood pressure: The natural remedy proven to lower your reading - Express [Last Updated On: October 7th, 2019] [Originally Added On: October 7th, 2019]
- Advanced Drug Delivery Systems Market Growth Analysis 2019 to Share Key Aspects of the Industry with the details of Influence Factors Forecast to 2024... [Last Updated On: October 28th, 2019] [Originally Added On: October 28th, 2019]
- The 9 Biggest Technology Trends That Will Transform Medicine And Healthcare In 2020 - Forbes [Last Updated On: November 6th, 2019] [Originally Added On: November 6th, 2019]
- Potential PF Therapy AD-214 to Move into Phase 1 Testing in Humans - Pulmonary Fibrosis News [Last Updated On: November 6th, 2019] [Originally Added On: November 6th, 2019]
- Edited Transcript of CYTK earnings conference call or presentation 31-Oct-19 8:30pm GMT - Yahoo Finance [Last Updated On: November 6th, 2019] [Originally Added On: November 6th, 2019]
- The Montreal Heart Institute celebrates its 500th heart transplant - GlobeNewswire [Last Updated On: November 6th, 2019] [Originally Added On: November 6th, 2019]
- Latest Research Report to uncover key Factors of Global Cardiovascular Repair And Reconstruction Devices Market - Market Research Base [Last Updated On: November 6th, 2019] [Originally Added On: November 6th, 2019]
- Global Cardiovascular Repair And Reconstruction Devices Market: Development History, Current Analysis and Estimated Forecast to 2025 - Market Research... [Last Updated On: November 29th, 2019] [Originally Added On: November 29th, 2019]
- The cardiac safety services market is projected to reach USD 752 million by 2024 from USD 442 million in 2019, at a CAGR of 11.2% - Yahoo Finance [Last Updated On: December 11th, 2019] [Originally Added On: December 11th, 2019]
- Evaluation of the Effect of Fish Oil Alone and in Combination with a P | DMSO - Dove Medical Press [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Amarin's Multiple Positives And Other News: The Good, Bad, And Ugly Of Biopharma - Seeking Alpha [Last Updated On: January 25th, 2020] [Originally Added On: January 25th, 2020]
- Heres What We Know About CBDs Effects On Varicose Veins - The Fresh Toast [Last Updated On: January 28th, 2020] [Originally Added On: January 28th, 2020]
- Hypertension: This Spice Can Help You Control High Blood Pressure Easily And Effectively - Doctor NDTV [Last Updated On: January 28th, 2020] [Originally Added On: January 28th, 2020]
- Cannabis Manual: Better Together - Weekly Alibi [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]
- Pharmacology: Cardiovascular Drugs 1 (30 Items) - Nurseslabs [Last Updated On: March 1st, 2020] [Originally Added On: March 1st, 2020]
- A central master driver of psychosocial stress responses in the rat - Science Magazine [Last Updated On: March 9th, 2020] [Originally Added On: March 9th, 2020]
- The Global Cardiac Safety Services Market is expected to grow from USD 419.45 Million in 2018 to USD 865.23 Million by the end of 2025 at a Compound... [Last Updated On: March 29th, 2020] [Originally Added On: March 29th, 2020]
- Milestone Pharmaceuticals Announces Topline Results from First-of-its-kind Phase 3 NODE-301 Trial of Etripamil for At-home Acute PSVT Treatment -... [Last Updated On: March 29th, 2020] [Originally Added On: March 29th, 2020]
- Fresh Produce In Short Supply? Prioritize This Veggie In Your Diet - mindbodygreen.com [Last Updated On: April 25th, 2020] [Originally Added On: April 25th, 2020]
- COVID-19: What's RNA research got to do with it? - University of Rochester [Last Updated On: May 1st, 2020] [Originally Added On: May 1st, 2020]
- What Happens When You Add Other Drugs To Your LSD Trip? - VICE [Last Updated On: May 1st, 2020] [Originally Added On: May 1st, 2020]
- Toward a Pharmacology of Resolution - Harvard Magazine [Last Updated On: May 1st, 2020] [Originally Added On: May 1st, 2020]
- GLYCOMIMETICS : MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS (form 10-Q) - marketscreener.com [Last Updated On: May 2nd, 2020] [Originally Added On: May 2nd, 2020]
- This Simple Breathing Advice From A Nobel Prize Winner Can Turn The Tables On Stress During The Coronavirus Lockdown - Forbes [Last Updated On: May 2nd, 2020] [Originally Added On: May 2nd, 2020]
- National Nurses Week 2020: What Experiences Have Shaped Your Nursing Career? - HealthLeaders Media [Last Updated On: May 2nd, 2020] [Originally Added On: May 2nd, 2020]
- Research Paper Stresses Importance of Repurposing Drugs Against COVID-19 - BioSpace [Last Updated On: May 13th, 2020] [Originally Added On: May 13th, 2020]
- Repurposing existing drugs to treat coronavirus will likely be quicker than a vaccine, scientists claim - CNBC [Last Updated On: May 13th, 2020] [Originally Added On: May 13th, 2020]
- Alzheimer's and Cannabis - Greenway - Greenway [Last Updated On: May 18th, 2020] [Originally Added On: May 18th, 2020]
- Moderna Highlights Advances in Platform Science and Innovative Vaccine Research at Third Annual Science Day - Business Wire [Last Updated On: June 2nd, 2020] [Originally Added On: June 2nd, 2020]
- Healthy people shouldn't take daily aspirin to prevent heart disease, review finds - WDJT [Last Updated On: June 6th, 2020] [Originally Added On: June 6th, 2020]
- Study reveals how living close to roadways may impact the brain - Drew Reports News [Last Updated On: June 18th, 2020] [Originally Added On: June 18th, 2020]
- Disruptions in circadian rhythms not only cause sleep disorders, but could also put you at risk of these... - Firstpost [Last Updated On: June 18th, 2020] [Originally Added On: June 18th, 2020]
- NeonMind Files Patent Application for Therapeutic Use of DMT - Yahoo Finance [Last Updated On: June 18th, 2020] [Originally Added On: June 18th, 2020]
- Vitamin D What you need to know about the sunshine vitamin - Medical News Bulletin [Last Updated On: July 9th, 2020] [Originally Added On: July 9th, 2020]
- Idorsia announces positive results in the second Phase 3 study of daridorexant - GlobeNewswire [Last Updated On: July 9th, 2020] [Originally Added On: July 9th, 2020]
- ATAI Life Sciences takes on opioid crisis by acquiring Kures to develop novel therapeutics for opioid abuse - PRNewswire [Last Updated On: July 9th, 2020] [Originally Added On: July 9th, 2020]
- Drug Discovery Outsourcing Market Highly Favorable with new Demand to the Growth Rate by 2027| Thermo Fisher Scientific, Merck KGaA, Albany Molecular... [Last Updated On: August 21st, 2020] [Originally Added On: August 21st, 2020]
- Bringing Peer Review To Early COVID-19 Research, More News - Bio-IT World [Last Updated On: August 21st, 2020] [Originally Added On: August 21st, 2020]
- Cardiac Safety Services Market Research Report by Type of Service, by Type, by End User - Global Forecast to 2025 - Cumulative Impact of COVID-19 -... [Last Updated On: August 21st, 2020] [Originally Added On: August 21st, 2020]
- UCI study finds women with diabetes and high levels of coronary artery calcium at greater risk of death than men - Newswise [Last Updated On: August 21st, 2020] [Originally Added On: August 21st, 2020]
- Globa Advanced Drug Delivery Systems Market 2020 Research, Key Players, Industry Overview, Supply and Consumption Analysis 2024 - Bulletin Line [Last Updated On: September 2nd, 2020] [Originally Added On: September 2nd, 2020]
- Esperion Announces Two Data Presentations of NEXLETOL (bempedoic acid) Tablet at the ESC Congress 2020 - GlobeNewswire [Last Updated On: September 2nd, 2020] [Originally Added On: September 2nd, 2020]
- Women with diabetes and high levels of coronary artery calcium at greater risk of death than men - UCI News [Last Updated On: September 2nd, 2020] [Originally Added On: September 2nd, 2020]
- 15 Clever Ways to Use Leftover Red Wine - Yahoo Lifestyle [Last Updated On: September 2nd, 2020] [Originally Added On: September 2nd, 2020]
- UK Study Leads to Better Understanding of Blood Pressure Regulation, Atherosclerosis - UKNow [Last Updated On: September 2nd, 2020] [Originally Added On: September 2nd, 2020]
- Academic always top of the class for pay and conditions - Extra.ie [Last Updated On: September 15th, 2020] [Originally Added On: September 15th, 2020]
- Cardiac Safety Services Market Size Is Rising Tremendously Due To Increasing Need of Healthcare Services Centralization Till 2025 - TC BizNews [Last Updated On: September 15th, 2020] [Originally Added On: September 15th, 2020]
- 5 Benefits of Berberine, Including Why It's a Healthy Gut All-Star - msnNOW [Last Updated On: September 15th, 2020] [Originally Added On: September 15th, 2020]
- Advanced Drug Delivery Systems Market 2020 Report Covers Key Growth Factors, Global Trends, Opportunities by Regions, Industry Size and Share... [Last Updated On: September 23rd, 2020] [Originally Added On: September 23rd, 2020]
- Janssen Presents Findings from Global, Multi-Center Trial Examining Amivantamab in Combination with Lazertinib in Patients with EGFR-Mutated Non-Small... [Last Updated On: September 23rd, 2020] [Originally Added On: September 23rd, 2020]
- MASSIVE GROWTH OF DRUG DISCOVERY SERVICES MARKET WILL RAISE USD 19.1 BILLION BY 2027, CAGR +13% FROM 2020 TO 2027 WITH TOP KEY PLAYERS LIKE THERMO... [Last Updated On: September 29th, 2020] [Originally Added On: September 29th, 2020]