Two lots to be exact. Firstly, the Attorney General from Iowa is asking regulators to reconsider the deeming regulations regarding e-cigarettes, and, there has been another positive Cochrane review.

But first, the Attorney General (AG) from Iowa.

Tom Miller is the AG for Iowa. He has a long and fruitful history with Tobacco. He was part of the team that sued the Tobacco Firms, resulting in the Tobacco Masters Settlement Agreement (TMSA), where the Tobacco Industry paid the US States billions of dollars for the harm tobacco does and did.

Tom Miller

It seems Miller has now turned his sights on the vaping world, and no surprise to us, (but it was for the HuffPost,) he is a supporter of vaping.

Miller was recently speaking to the Food and Drug Law Institute, where, according to the Huffington Post, “Miller expressed concerns about misleading messages coming from tobacco control groups and government agencies with whom he’s worked side by side for decades.”  He harshly criticized a misleading ad from the Centers for Disease Control.

Miller is also the author of an open letter to the FDA Chief Steve Gottlieb, where he and 12 other global Public Health leaders asked the FDA to improve the regulatory framework for e-cigarettes. The letter calls on the Agency to take action to avoid unnecessary damage to the market for innovative and disruptive technology “.

Tom Miller speaking

The letter proposes a four-year delay in enforcement of the requirement for a Pre-market Tobacco Application (PMTA), with a new framework that should be based on clear and transparent standards made through an open and consultative process.

Clive Bates, a global vaping advocate called this letter along with one other, ”a powerful call for new thinking in United States tobacco policy from some of the most respected figures in the field.”

While talking to the Food and Drug Law Institute, Miller stated, “What troubles me and bothers me a lot is that the American public does not realize that e-cigarettes are dramatically less harmful. The misconceptions are amazing and extremely troublesome.”

Miller wants the USA to behave more like the English when it comes to e-cigarettes, where the English public bodies have all basically agreed that e-cigarettes are less harmful than their tobacco counterpart.

The Cochrane Review:

The Cochrane Database of Systematic Reviews (CDSR), is the leading resource for systematic reviews in health care.

It is global non-profit group that reviews all the evidence on healthcare interventions and summarizes the findings, providing unbiased information so allowing professionals and lay people alike to make difficult choices, without having to read every study on a given health topic.

Studies from the Cochrane database are globally held in high regard.

The latest study regarding e cigarettes from Cochrane, has been graded as low, because there haven’t been many high-quality studies.  However, this does not mean the evidence should be discarded or dismissed.

Writing in the UK broadsheet newspaper ‘ The Guardian, the lead author of the latest Cochrane e-cigarette review,  Jamie Hartmann-Boyce, details why it should not be dismissed. (Jamie is an author and editor of the Cochrane Tobacco Addiction group, based at the Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK).

In the newspaper article, she discusses why there are different outcomes obtained with studies researching if vaping can help people quit. Some say they can, others say they don’t.

She writes, “by randomly assigning people to one intervention or another and measuring the outcome in the same way across both groups, you can rule out alternative explanations for differences between groups. The reviews that find e-cigarettes help people quit smoking only include randomized controlled trials. The studies (like this one and this one) that find that e-cigarettes stop people from quitting aren’t randomized controlled trials – instead they survey smokers and ask if they are using e-cigarettes. Then, some months later, they ask the same people if they are still smoking. We don’t know if the results from these studies reflect the effect of vaping, or if something else about the vapers makes it harder for them to quit. For example, it might be reasonable to imagine they are more dependent smokers, which is why they vape as well as use regular cigarettes. This would make quitting harder.”

So even though the studies are of lower quality than we and many would like, i.e. surveys instead of randomized controlled trials, the Cochrane findings are positive.

She continues, “While our conclusions are limited because there aren’t many high-quality studies available yet, overall the evidence suggests that (1) e-cigarettes with nicotine can help people quit smoking, (2) they don’t seem to have any serious side effects in the short- to mid- term (up to 2 years), and (3) in some cases, switching to them leads to changes in your blood and breath that are consistent with the changes you’d see in people who give up smoking altogether.”