Bloomberg News: FDA Says Smokers May Have Higher Risk of Catching Covid-19

This article appeared on the Bloomberg News website on April 21. To read the full article, please click here.

FDA Says Smokers May Have Higher Risk of Catching Covid-19

By:

The U.S. Food and Drug Administration made a second revision on its stance about the risks of Covid-19 and nicotine, saying that cigarettes also increase the chances of catching the disease.

“People who smoke cigarettes may be at increased risk of infection with the virus that causes Covid-19, and may have worse outcomes from Covid-19,” the agency said in an emailed response to a question from Bloomberg News.

Earlier this month, the FDA had said that smokers may have worse outcomes from Covid-19, but hadn’t been explicit about whether that included their chances of catching the virus in the first place.

The clarification comes as researchers and regulators race to study the new virus. There are nearly 2.5 million confirmed cases and more than 171,000 deaths worldwide from Covid-19. The world’s estimated 1.1 billion people who smoke and 41 million people who vape have so far gotten varying guidance on the virus’s potential threat from public health agencies.

Cigarette manufacturers, like Marlboro maker Philip Morris International Inc., say people should look to governmental health authorities and medical professionals for advice. “Nicotine and tobacco products are not risk-free, and the best thing anyone can do is to quit altogether. Those who do not quit smoking should consider switching to regulated smoke-free alternatives to cigarettes, such as e-cigarettes and heated tobacco products,” Philip Morris spokesman Corey Henry said.

With a disease that has only been studied for a few months, regulators and researchers have looked to old data on how cigarette smoking effects those with the flu, bronchitis and pneumonia. They’re also pressing ahead on new studies on vaping, which hasn’t been around as long as smoking. The FDA noted in its April 14 statement that cigarette smoking “causes heart and lung diseases, suppresses the immune system, and increases the risk of respiratory infections.”

In its March 27 statement on the risks, the FDA had said that vaping and smoking only posed a higher risk for the coronavirus in people who had underlying conditions.

Some groups have said vaping may be safer than smoking.

The FDA said in its prior statement that the effects of vaping on Covid-19 are unknown, while cautioning that it exposes the lungs to toxic chemicals.

(Updates to include Philip Morris comment in the fifth paragraph)

LA Times: Tobacco, vaping industries seize opportunities in coronavirus with freebies, donations

This article appeared online for the LA Times on April 17. The full article can be accessed by clicking here

Tobacco, vaping industries seize opportunities in coronavirus with freebies, donations

Running low on surgical masks during the pandemic? You can get two for free by ordering a Moti Piin, a battery-powered vaping pen, from the company’s online shop.

Or buy sleek cartridges from Smok, another e-cigarette brand, and earn chances to win disposable gloves and up to 10,000 masks.

“COVID19 RELIEF EFFORT” blasts the ad of another online shop offering two-for-one e-liquid vials. Buyers at another shop get 19% off nicotine e-juices if they enter the code COVID-19.

As the global pandemic strains the world’s inventory of medical supplies, the tobacco and vaping industries are taking advantage of a unique opportunity, offering freebie protective gear, doorstep deliveries and festive pandemic-themed discounts. Some players have donated ventilators and mounted charity campaigns.

The tobacco companies insist they are simply doing their part to help during the crisis. But the coronavirus-related marketing has been criticized by anti-smoking advocates who call it hypocritical and potentially dangerous. They note that people with lungs damaged by smoking are at an elevated risk if they catch the virus, and that vaping has been linked to a growth in tobacco use, particularly among teens.

“It’s as if they don’t realize they’re in the business of destroying lungs,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “It literally takes your breath away. It makes the word ‘hypocrisy’ feel feeble.”

Researchers have long known the dangers of tobacco products, which kill more than 8 million people each year, according to the World Health Organization. Smoking weakens a person’s ability to fight off respiratory infections and drives up their risk of developing the types of chronic lung conditions that underlie many of the most severe coronavirus cases.

Health officials are adding the pandemic to their long list of reasons that people should quit. E-cigarettes can be efficient carriers of the virus, they note. They are often passed around and shared; smokers frequently touch their face and mouth. The smoke and vapor that waft through the air could spread infectious particles to people and surfaces nearby, say scientists.

But the American Vaping Assn. circulated an editorial in late March that urged state officials to lift bans of online e-cigarette sales, arguing that online sales promote safety because it keeps people from making trips outside their home. Continued access to e-cigarettes prevents people from relapsing back into smoking cigarettes, they added.

In one doorstep delivery promotion, a woman beams as she opens her vaping package, her fists raised in the air. In another, hand-in-hand models ask customers to help “build a community with a shared future for humanity.”

“Hurry and save today,” an Instagram ad said, with the hashtags #corona, #quarantine, #vapenation.

Research published in American and Chinese journals already suggests that tobacco users often fare worse with coronavirus infections. The effects of vaping on a case of COVID-19 are less conclusive, but scientists say a surge of lung infections tied to the habit last summer gives them reason for worry. “Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape,” the National Institute on Drug Abuse, part of the National Institutes of Health, warned in a statement last month.

The tobacco industry has used the moment to enhance its public image, especially with charitable giving. The world’s biggest tobacco company, Philip Morris International, donated 50 ventilators to the government of Greece, which has one of the highest smoking rates in Europe. The country has seen 2,100 cases of COVID-19, and at least 100 people have died.

The company, which holds 40% of the Greek tobacco market, did not appear to publicize its donation and did not respond to an inquiry from The Times.

Gov. Ralph Northam of Virginia has asked tobacco companies to take on a similar role and supply respirator masks in the United States.

Altria, the maker of Marlboro cigarettes, announced a $1-million relief investment to help support vulnerable residents surrounding its headquarters in Richmond, Va., and other regions where manufacturing takes place. Caring for each other and doing what’s right is core to our company,” Jennifer Hunter, the company’s senior vice president for corporate citizenship, said in a statement.

Altria said in a statement that its companies were “working to protect their employees, consumers and communities from the virus.”

Meanwhile, vape manufacturers and retailers are donating bottles of hand sanitizer to local police and fire departments across the country, according to the Smoke-Free Alternatives Trade Association.

Individual vaping companies did not respond to inquiries from The Times.

In Los Angeles, smoke shops have been among the businesses most resistant to orders that they close. Los Angeles prosecutors have filed criminal charges against two smoke supply establishments, accusing them of refusing to comply with the city’s strict Safer at Home order intended to slow the spread of the virus.

On the store shelves, N95 respirators and hand sanitizer tubes are stacked beside glass bongs and e-liquids. “TIMES ARE TUFF,” one shop’s signage read. “WE GOT YOU.”

“We had a smoke shop that just refused to close,” Mayor Eric Garcetti said. “And even when police officers were there, they said, ‘Forget you’ — probably not in as nice words — ‘we’re not going to do it.’” He said the city was going to move to shut off the shop’s power.

Unexpectedly high numbers of younger people have become severely ill from the virus, and some experts suspect a link to vaping. “The COVID-19 crisis should be a wake-up call that your age doesn’t matter if your lungs are compromised,” Myers said.

Most of the companies’ websites still include legally required disclaimers about age restrictions. But the flavors range from Oatmeal Cookies and Yogurt Drink to Blueberry Parfait and Watermelon Rush, a colorful cartridge displayed in its promotion next to a bright glass of juice. The Food and Drug Administration attempted to ban such flavors years before the trend ballooned among teenagers, only to have the plan rejected by top White House officials, a Times investigation found last year.

There may be a silver lining to e-cigarette sales during the extended quarantine. It’s much harder for addicted teenagers to keep the habit a secret, Myers said.

“Tens of thousands of parents are likely realizing for the first time: Their kids are definitely still vaping.”

AL.com: Is vaping essential? Why smoke shops are open during the shutdown

This story appeared on al.com website on April 12. The story follows how Alabama’s vape shops are staying open and what it means for their public health. The link to the original story can be found here.

Is vaping essential? Why smoke shops are open during the shutdown

Business is booming inside the 1st Avenue Hookah and Vape Shop in the Avondale neighborhood of Birmingham where Don Scott is fielding orders for hookahs and vapes and pipes during a respiratory pandemic.

The small vape and smoke shop remains open, omitted from a list of “essential” business but also not included among the businesses listed for closure under Alabama Gov. Kay Ivey’s stay-at-home order.

If people maintain 6-feet social distancing, and the capacity is restricted inside the store, the tobacco and electronic cigarette sales can go on.

“We are doing it safe here, we have hand sanitizers, and our sales have gone up,” said Scott. “They’ve not stopped.”

The fact that vape shops throughout Alabama remain open is a concern for anti-smoking advocates and state lawmakers who, in recent years, pushed for a crackdown on an industry accused at times of peddling flavored products to underage youths.

But what is going on in Alabama is not uncommon across the U.S., where governors have issued stay-at-home orders that do not address vape or smoke shops. According to a review of 40 state stay-at-home orders issued last month, “there isn’t a single state order that has designated a vape shop as an essential business,” according to Boot Bullwinkle, spokesman with the Campaign for Tobacco-Free Kids.

Even though vape shops are not considered “essential business,” they remain open in many cases, Bullwinkle said.

“For example, whereas some states require all non-essential businesses to close, some states allow non-essential businesses to stay open if they maintain social distancing rules, and some state orders specifically encourage non-essential businesses to adopt curbside delivery or other remote means to conduct their business,” he said.

‘Tragic’

That is the case in Alabama, where the state Department of Public Health – in a FAQ sheet answering questions about Ivey’s order – recommends that businesses like “tobacco stores” deliver products to people’s homes or meet customers at the curb.

The FAQ sheet also poses the following question, “Before asking whether you can legally do X, Y, or Z, ask yourself, ‘Is doing X, Y, or Z a good idea?’ If doing X, Y, or Z would increase the risk of transmitting COVID-19, try not to do it.”

Still, neon lighted “Open” signs remain affixed to the front doors of many vape shops around Alabama.

Some lawmakers are concerned they are allowed to remain open during a pandemic in which the spreading virus attacks the lungs.

“It’s very tragic,” said state Rep. Barbara Drummond, D-Mobile, who has backed legislation adopted last year that restricts stores from selling nicotine and vape products to people under 19. “If you look at the data coming out of the Department of Public Health, this disease is a great equalizer. But those with an underlying illness and with a bad habit such as smoking and vaping, they are (more) prone.”

The Campaign for Tobacco-Free Kids, in an Op-Ed piece published April 2 in the Denver Post, wrote that vaping may worsen the effects of COVID-19 by attacking the lungs, placing people who vape at greater risk than people who do not.

Dr. Alan Blum, director of the University of Alabama’s Center for the Study of Tobacco and Society, said the pandemic should allow smokers time to find better ways to control their nicotine additions through either “simple relaxation exercises” or other means such as eating more fruits and vegetables.

“We need to be sympathetic to those who are using electronic cigarettes to stop smoking, but at a time when one of the worst viruses we have ever seen is taking aim at our lungs, the last thing anyone should be doing is inhaling nicotine either from a cigarette or an e-cigarette,” Blum said. “Right now, the only sensible way to reduce one’s nicotine craving would be to use a nicotine-containing patch, gum or lozenge.”

Demand remains

Gregory Conley, president of the American Vaping Association and an attorney in New Jersey, said there is no evidence linking vaping to “any COVID-19 outcome.”

He said the past lung illnesses and deaths linked to vaping were the result of “illicit” use of THC-containing e-cigarettes dealt “on the black market.” The Centers for Disease Control and Prevention along with state and local health authorities, reported a spike in vaping-related lung illnesses in August and September 2019. But ever since then, the CDC reported in February, they’ve been on a decline.

Conley said that linking coronavirus and vaping is done by people “to generate headlines on their pet political issue.” He said that pushing for vape shops to close could lead to more people turning to cigarette smoking to get their nicotine fix during the pandemic.

In Alabama, 20.9% of adults are smokers, according to the most recent World Health Organization figures. That’s the 10th highest in the U.S.

Conley said that vape stores, like other small businesses struggling during the pandemic, “not hitting the revenue numbers they had three months ago.” Online sales, he said, are trended upward.

“But there is a demonstrated need for these products among ex-smokers who rely upon them to stay away from cigarettes,” he said. “The demand for the product who need it the most remains through the potentially life-changing pandemic.”

Lobbying strength

The ability for vape and smoke shops to remain open, while restaurants and bars are closed, has raised eyebrows among those who follow Alabama politics. Restaurants are allowed to deliver meals to houses and offer curbside service, but the delivery of alcoholic beverages in Alabama is prohibited.

Keith Herbert, a history professor at Auburn University who specializes in the history of Alabama and Southern culture, said effective lobbying by tobacco interests is probably one reason why the shops are spared from temporary closures.

He said that lobbying influences affected President Donald Trump — who at one point expressed interest in tough crackdowns against flavored e-cigarettes – to relent to a more limited ban on sales of flavored vaping pods. Trump reportedly expressed regret, during a January phone call with Health and Human Services Secretary Alex Azar, for getting involved in vaping regulations.

Herbert compared the strength of tobacco lobbying to the restaurant and bar industry.

“Unfortunately, I suspect that if (restaurants and bars) had a national lobbying organization aligned with a particular ideological view capable of motivating the electorate, they might too have been spared from stricter regulations,” Herbert said.

Tobacco stocks, meanwhile, haven’t been hammered during the pandemic. Tobacco shops in Italy and France – among supermarkets and pharmacies – were a few of the businesses allowed to remain open during their lockdowns.

“Pragmatically, there is a case for keeping the ‘vice-related’ businesses operational; other countries kept their tobacco stores open throughout this period,” said Robert Blanton, chairman of the Department of Political Science and Public Administration at the University of Alabama. “Health reasons aside – and that’s a big aside – it would be difficult to force a smoke-to-quit (effort) during a quarantine period.”

ABC23: Family warns of symptoms and health dangers of vaping

This story was posted on ABC23’s website on April 14. ABC23 serves Bakersfield, California. The original link to the story can be found here

Family warns of symptoms and health dangers of vaping

Posted at 8:41 PM, Apr 14, 2020

BAKERSFIELD, Calif. — This past march 16-year-old Ryker Schamblin had a cough along with nausea and vomiting for about a week. So, his parents took him to urgent care where he got an x-ray, doctors thought he had pneumonia and prescribed standard medications and sent him home.

A few days later Ryker hadn’t improved and was still having trouble breathing, so they took him to the emergency room.

“Immediately kind of thought it was a COVID to be honest with you. He had the clinical picture of a COVID presentation,” said Mark Schamblin, Ryker’s dad.

Ryker was immediately admitted into the intensive care unit. He was put on oxygen, and given an x-ray, CT scan and was tested for COVID-19. After his first night in the ICU his breathing worsened, and doctors said he had acute respiratory distress syndrome also known as ARDS. The next morning doctors told his parents his x-rays were ten times worse and he needed to be intubated immediately.

“As dad it’s a nightmare. I’ve said often times if there’s one thing that could break me it would be losing a kid or losing him. So, as a dad it’s painful and as a doctor who’s seen these things sometimes go the wrong way, you can’t help but panic that he’s not going to come out of it,” said Mark.

Ryker’s doctors began some treatment but were waiting for the result of his COVID-19 test to ensure the next best course of treatment. The hospital even sending the COVID-19 test out of town to get faster results.

His test came back negative but while the nurses prepped Ryker for the ventilator, they found a clue that lead to the right diagnoses, vape pens.

Ryker was placed on a RotoProne bed, used to treat acute respiratory distress. Part of the bed treatment required him to be placed facedown for 16 hours. His family said it was hard to sign off on the treatment once they saw the risks which included, facial disfiguration, blindness and skin wounds.

“That was the hardest part was while he was on the RotoProne bed because we couldn’t see him,” said Dana Schamblin, Ryker’s mom.

After eight days of being in a medically induced coma and a series of breathing tests, Ryker finally began to recover.

His parents said they took pictures because, “We wanted him to be able to see them and see what he went through. I mean our word versus – pictures speak for themselves,” said Dana.

Ryker is home now recovering, he lost 30 pounds in the hospital and said he never thought this would happen to him. He also hopes he can let other people know the danger of vaping.

“Just don’t do it. You don’t want to go through that, you don’t want to see your parents cry, you don’t want to see any of that there’s no point,” said Ryker.

Vape Industry Trying to Lobby Federal, State Governments as “Essential Businesses”

Vaping is not an approved method of cessation- Surgeon General Vice Admiral Jerome Adams made that very clear during his 2020 Smoking Cessation report. Still, the industry is fighting at the state and federal level to stay open as an “essential business.”

The World Health Organization says smoking can increase your risk of catching COVID-19 and lead people who smoke to have more serious complications. Our friends at the Campaign for Tobacco Free Kids (CTFK) released this statement in response to the reports:

 

Absurd and Irresponsible: Vape Shops Claim They Are Essential When Vaping May Worsen Effects of COVID-19 and Has Addicted Millions of Kids

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
April 15, 2020

WASHINGTON, D.C. – As we combat the coronavirus, it has never been more important to have healthy lungs. So it is absurd and irresponsible for vape shops to claim they are essential businesses that should be allowed to remain open during the COVID-19 shutdown. How in the world can vape shops make these claims when over 5 million kids use e-cigarettes and there is mounting concern among public health experts that smoking and vaping can worsen the effects of COVID-19? Vape shops should not be allowed to exploit a lung health crisis to push products that harm your lungs – especially products often sold in kid-friendly flavors like mint, gummy bear and cotton candy.

News reports indicate vape shops are lobbying the Trump Administration to be listed as essential, and they have similarly lobbied states and cities across the country. The Administration and other policy makers must reject these efforts. Now more than ever, our priority should be protecting the health and lungs of kids, not the special interests of vape shops.

The reasons to reject these vape shop appeals are clear.

The coronavirus attacks the lungs, and behaviors that weaken the lungs put individuals at greater risk. The harmful impact of smoking on the lungs is well documented, and there is growing evidence that vaping can harm lung health as well. Dr. Nora Volkow, Director of the National Institute on Drug Abuse, recently noted, “Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape.” The Food and Drug Administration, which regulates e-cigarettes and other tobacco products, has publicly stated that people with underlying health conditions are particularly at risk, and this “includes people who smoke and/or vape tobacco or nicotine-containing products.”

Even before the COVID-19 crisis, e-cigarettes were addicting a new generation of kids and reversing decades of progress in reducing youth tobacco use. According to the 2019 National Youth Tobacco Survey, e-cigarette use among high school students nationwide increased to 27.5% in 2019 compared to 11.7% in 2017. Altogether, more than 5.3 million middle and high school students now use e-cigarettes.

While youth e-cigarette addiction has risen sharply, there is scant evidence that e-cigarettes benefit public health. Earlier this year, the U.S. Surgeon General issued a comprehensive report based on the best available evidence that found “there is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation.”

It is highly irresponsible to argue that e-cigarettes should be considered essential when they could well put users at greater risk for serious complications from COVID-19, they are addicting our kids, and they have not been proven to help smokers quit. Rather than protecting vape shops, policy makers should act now to help more smokers and vapers quit and to prevent kids from ever starting to use tobacco products, including by prohibiting all flavored tobacco products. The coronavirus pandemic should serve as a wakeup call to make our lungs healthier now and for the future.

CNN Health: Now’s the time to quit smoking: It could increase your odds of beating Covid-19

This article appeared on CNN Health’s webpage on April 3, 2020. The original link to the article can be found here.

Now’s the time to quit smoking: It could increase your odds of beating Covid-19

By Ryan Prior

(CNN)If you’ve been thinking about quitting smoking, there’s no time like the present pandemic.

With the novel coronavirus sweeping the globe, the science on quitting smoking offers welcome news for smokers who want to build up their defenses in case they contract Covid-19.
Though it may still take many months for a smoker’s lungs to heal from damage caused by long-term smoking, your health can noticeably improve in the days and weeks after quitting in ways that could make a difference against the virus.
Although you can’t reverse scarring to your lungs caused by smoking, there are a number of ways your lung health can improve in the short term, according to the US Centers for Disease Control and Prevention.

Time to strengthen your lungs

“Every lung doctor in America will be preaching that everyone should quit smoking.” Dr. Brian Christman, a volunteer spokesman with the American Lung Association and a professor of medicine at Vanderbilt University, told CNN. While this message isn’t new, it’s more relevant than ever.

Covid-19 creates an added sense of urgency, and there’s ample reason to believe that quitting smoking during the pandemic could increases your odds of fighting off the virus.
If you make the decision to quit, the cilia in your lungs are one of the first parts of your body to heal. These hair-like projections wave back and forth like a brush as air moves in and out of your lungs. They help your body fight off colds and infection, the CDC says. They also help clear mucus, so if they’re not functioning as well as they should, mucus can build up in the lungs.
Your body’s inclination to cough during an infection helps activate the bodily process of clearing out mucus, called the mucociliary escalator. That’s vital in fighting the Covid-19 condition.
The elderly are at a greater risk for excessive lung fluid that often limits breathing following coronavirus infection because “old folks don’t have a strong enough cough to clear it up,” Christman said.

Quitting can reduce inflammation

A second short-term gain from quitting smoking comes from reducing ongoing inflammation in your body, which can predispose you to Covid-19.
“If you quit smoking, the chronic inflammation goes away after a few weeks,” Christman said.
You’ll notice you won’t have as many symptoms of being short of breath when walking or climbing stairs, the CDC says.
Christman noted that smokers tend to need several months to stop producing higher levels of mucus, which their lungs create in order to clear out tar and other particulates contained in cigarettes.
“In terms of structural change, it takes a little while to clear the whole space,” he said.
Having your lungs in as good of shape as you can in case of a coronavirus infection is key. Covid-19 patients frequently experience acute lung injury, which can cause leakiness in mucus membranes, leading to what’s called acute respiratory distress syndrome, Christman said. This condition can result in patients drowning in their own mucus.
For smokers, “at baseline you’re set up for chronic bronchitis,” Christman said. “With Covid, it gets worse.”
And even if you’re not living in an area where there are numerous coronavirus cases, your decision to quit smoking might pay off down the road. That’s because public health authorities have projected multiple waves of cases over the next 18 months could be possible.
“It’s an investment in the future,” he said. “Covid might circulate in the Southern Hemisphere and then come back. Someone quitting now might really help themselves in the second wave.”

Respiratory failure is a common cause of death

For those who are diagnosed with Covid-19 and either fall seriously ill or die from it, respiratory failure or significant lung damage is common.
According to the CDC’s Morbidity and Mortality Weekly Report through March 28, 78% of US Covid-19 cases requiring intensive care unit admission came from patients who self-reported a recognized risk factor or a diagnosis of at least one underlying medical condition.
Current or former smoking status was among the shortlist of risk factors, along with other traits known to put people at risk for respiratory illness, including pregnancy. The most commonly reported underlying conditions included diabetes, chronic lung disease, cardiovascular disease, and immune compromised conditions.

Quitting smoking helps with blood circulation

Besides lung-related issues, smoking cessation can also deliver healthy benefits to the heart that could help stave off the possibility of cardiac arrest. Heart attacks are another cause of death in Covid-19 cases.
After you quit smoking, your blood becomes thinner and less susceptible to clotting, the CDC says. Heart attacks are less likely. One reason this happens is because smokers inhale carbon monoxide, and thereby diminish their capacity to carry oxygen and make it harder for the heart to distribute blood throughout the body.
“There is the occasional patient with Covid who dies from heart failure,” Christman says. He noted that in some cases, clinicians were seeing patients with elevated levels of troponins — a sign of heart attack that can be triggered by a severe infection.
You may already be practicing social distancing, washing your hands frequently and avoiding touching your face. In addition to all these, limiting or quitting smoking is yet another important aspect of your anti-coronavirus arsenal.
“Now is the time to take care of yourself,” Christman said.

Bloomberg News: FTC Sues to Unwind Altria’s $12.8 Billion Juul Investment

*April 6 Update* The Federal Trade Commission posted the complaint on their website. You can read the complaint by clicking here.

 

This article appeared on Bloomberg’s Business News webpage on April 2. The original link to the story can be found here

FTC Sues to Unwind Altria’s $12.8 Billion Juul Investment

By: and 

U.S. antitrust officials sued to reverse Altria Group Inc.’s troubled $12.8 billion deal to take a stake in vaping company Juul Labs Inc., saying the companies are competitors who shouldn’t be in business together.

The move further chips away at a much-heralded late 2018 deal that was supposed to combine the marketing might of Marlboro maker Altria with the savvy cool of Silicon Valley startup Juul. Instead, Altria has written down the investment twice, slashing the 35% stake’s value to $4.2 billion in January as health concerns about e-cigarettes led to a regulatory crackdown. Nonetheless, Altria vowed Wednesday to defend the deal.

The Federal Trade Commission’s complaint argues that Altria and Juul were aggressive rivals until Altria decided to end the competition by shutting down its own e-cigarette brands, MarkTen and Green Smoke, before acquiring its stake in Juul.

“Altria and Juul turned from competitors to collaborators by eliminating competition and sharing in Juul’s profits,” Ian Conner, director of the FTC’s Bureau of Competition, said in a statement

The complaint is the latest hurdle for the deal, which gave the largest U.S. cigarette maker a piece of the nation’s largest e-cigarette maker and was criticized from the start. Altria investors bemoaned the price tag and longtime Juul employees said the transaction flew in the face of Juul’s stated mission to rid the world of cigarettes.

The FTC’s challenge could cost Altria its piece of the e-cigarette market, which had appeared to be an avenue for growth as smoking rates decline and the market for tobacco shrinks. At the same time, it could release the company from the troubled investment. Complicating the process for Altria is the fact that Chief Executive Officer Howard Willard has contracted Covid-19 and has taken a medical leave of absence.

Altria shares gained 0.9% to $37.95 in premarket trading Thursday. Through the close of trading Wednesday, the stock had fallen 25% this year, roughly in line with the drop in the broader market caused by the coronavirus crisis.

“We believe that our investment in Juul does not harm competition and that the FTC misunderstood the facts,” Altria General Counsel Murray Garnick said in a statement. Juul declined to comment.

For Juul, it poses yet another hurdle for the embattled company to overcome as it grapples with investigations of its business practices that allegedly helped spark a surge of underage vaping. The company is now a target of federal investigations and lawsuits from parents and school districts. The FTC also has a separate probe into the company’s marketing.

Juul and other e-cigarette makers must soon submit applications to the Food and Drug Administration to continue selling their products in the U.S.

It’s unclear how the investment could be unwound. Juul has spent the bulk of the $12.8 billion to pay out investors and award bonuses to its employees. Other Juul investors include Fidelity Investments and Tiger Global Management. Altria was supposed to gain voting rights and board seats at Juul with antitrust clearance.

Unanimous Vote

The FTC’s five commissioners voted unanimously to file a complaint in its administrative court and a trial has been scheduled to begin on Jan. 5, 2021. The complaint threatens to tie up Altria in litigation for months. The cases are heard by an administrative law judge and then by the full five-member commission. Decisions can be appealed to federal court.

The complaint, which hasn’t been made public, follows a year-long investigation by the FTC into whether Altria’s investment violated antitrust laws.

In October 2018, Altria pulled its pod-based e-cigarette products from the market and sent a letter to Scott Gottlieb, then the commissioner of the Food and Drug Administration, blaming products like Juul’s for fueling a teen vaping epidemic. Two months later, Altria closed its e-cigarette business entirely and then announced its Juul investment.

As part of the deal, Altria gave Juul some of its shelf space and promised its help with an upcoming regulatory application that will determine whether Juul can continue to sell its e-cigarettes in the U.S. In the fall of 2019, a longtime Altria executive who pursued the investment, K.C. Crosthwaite, took over as Juul’s CEO and hired Altria colleague Joe Murillo as Juul’s chief regulatory officer.

Health Scare

Juul, once among the most valuable start-ups in the U.S., saw its fortunes quickly diminish last year. A health scare that was later tied to faulty cannabis vaping products spooked consumers and prompted governors and state regulators to crack down.

The company laid off about 650 people last fall and implemented a $1 billion restructuring plan. A number of executives have left amid the shake up. Co-founder James Monsees and Chief Transformation Officer Guy Cartwright both left within the past month.

Altria has been “highly disappointed” in the investment, CEO Willard said in January. Lawsuits accusing Juul of hooking minors to nicotine have ballooned, including many that name Altria as a co-defendant. The company has since narrowed the terms of its cooperation with Juul away from marketing and solely to gaining regulatory approval.

FTC Scrutiny

The FTC is increasingly questioning deals where upstart competitors are swallowed up by established players. In February, the agency demanded new information about startup acquisitions by Alphabet Inc., Apple Inc., Amazon.com Inc., Facebook Inc. and Microsoft Corp. that had previously flown under its radar to determine whether they should have been blocked. The same month, the FTC sued to block the merger of Edgewell Personal Care Co., the maker of Schick razors, with Harry’s, the shaving-supply company.

The U.S. Securities and Exchange Commission is investigating the Altria-Juul deal, according to a report last month from the Wall Street Journal.

(Updates stock-price information in seventh paragraph. A previous version of this article corrected the date that Altria closed down its e-cigarette business in 14th paragraph.)

Post Bulletin: I’m a smoker … And along comes a pandemic

This article appeared online for the Post Bulletin out of Minnesota. It was published on March 31. The original article can be read by clicking here.

 

I’m a smoker … And along comes a pandemic

Matthew Stolle mstolle@postbulletin.com

Mar 31, 2020 Updated Apr 1, 2020

It’s never been a great time to be a smoker. Now in the midst of a pandemic, it just got riskier for smokers.

Yet smoking is a coping mechanism for many, and pandemics are nothing if not stressful.

Dr. J. Taylor Hays, director of the Mayo Clinic Nicotine Dependence Center, talked with the PB about the heightened risks smokers face and why now might be the time to quit.

PB: Why are smokers at risk for COVID-19?

Hays: Several things are at play. One of the more obvious ones is that smokers have a higher risk for all kinds of conditions that are associated with more risk of complications from COVID-19. So, for example, chronic lung disease, COPD, emphysema. People with chronic lung disease have a higher risk of complications and more serious and critical infections.

More specifically, we know that smoking decreases the ability of the lungs to fight infection. The main thing that smoking does is impede the clearance of mucus from the lungs. We have in our lungs little hairs on the cells called cilia that beat in a coordinated fashion and move the mucus we produce up (towards the throat). That’s how we clear infections.

In smokers, those cilia don’t work. They’re paralyzed.

PB: So if I’m a smoker, I’m more susceptible to COVID-19. And if I get the infection, my symptoms are more likely to be more severe. Is that right?

Hays: More complicated, more severe, longer recovery time. Greater chance of having to go to the hospital, developing lower respiratory infections and pneumonia.

Early data from China suggests that smokers were over-represented among the people who had severe and critical illness, who had higher risk of mortality from the COVID infection.

PB: Here’s a hard-hearted question: Smokers know the risks. Why should I care?

Hays: You’re right. People do make choices in their lives. And some of those choices end up costing them. And in this case, the cost could be dear. But my comeback to that is: Because of the nicotine in tobacco causes addiction, people really lose the ability to choose.

So if a chemical is driving the urge to smoke and causing withdrawal around quitting, those are hallmarks of addiction.

Also, smoking doesn’t just impact you. It impacts people around you. If you’re inside your house, which we all are, and you’re smoking, second-hand smoke exposure is also a risk factor for more serious COVID 19 infection.

PB: Let’s say the pandemic scares me enough to consider stop smoking. If I stopped now, would I get any appreciable benefits?

Hays: The answer to that is an unequivocal yes. We know that within hours of stopping, respiratory symptoms begin to improve. Within days, the clearance of mucus begins to improve.

PB: What is the percentage of people who smoke?

Hays: It’s gotten a lot better in the U.S. We’re now down for all adults to 15 percent to 17 percent in most states. In Minnesota, we’re probably down to 14 percent. That’s the lowest we’ve been since before World War II.

PB: Do the risks you describe also apply to marijuana smokers and people who vape?

Hays: The answer to that is unknown. We presume that if you inhale any combustible product or e-cigarettes, that it can cause some irritation to the lung. That’s probably not a good thing to do. If you’re exposed to COVID and have to fight an infection, we presume it would increase your risk. But there’s no data on that yet.

Those interested in quitting can find more information by calling 1-800-quit-now, a national quit line. You can also access information at becomeanex.org.

 

Forbes: Smokers At Higher Risk Of Severe COVID-19 During Coronavirus Outbreak

This article from Forbes.com was posted on March 23. Link to the article found here

Victoria Forster

Contributor; Healthcare
Cancer research scientist and childhood cancer survivor.

A leading expert has warned that smokers are likely at increased risk of more severe COVID-19, compared to non-smokers, suggesting that now would be a particularly good time to try and quit or cut down.

“There’s not very much data at this point on COVID-19 in smokers, but we do know from reports from China, smokers seem to be over-represented in groups of people who have severe or critical COVID-19,” said J. Taylor Hays, M.D. Director of the Nicotine Dependence center at Mayo Clinic in Rochester, Minnesota and Professor of Medicine, Mayo Clinic College of Medicine.

Increasing evidence is suggesting that smokers are at higher risk of severe COVID-19 than those who don’t smoke. One study published in the New England Journal of Medicine in February looked at 1,099 patients in China with COVID-19, showing that of 173 patients who had severe symptoms, 16.9% of them were current smokers and 5.2% had previously smoked. Among the patients with less-severe symptoms, 11.8% were current smokers and 1.3% former smokers.

More worryingly, the study showed that in a group of patients that either needed mechanical ventilation, admission to an intensive care unit, or ultimately died, 25.5% were current smokers, which was more than twice the rate of current smokers in a group of patients that did not have these severe adverse outcomes.

“These observations about more severe illness in smokers vs people who have never smoked seems to parallel what is seen in respiratory viruses such as respiratory syncytial virus and seasonal influenza, where smokers tend to do worse than non-smokers,” said Hays, also mentioning that no data is currently available on people who vape or use e-cigarettes. “We know that inhalation of combustible tobacco of any sort seems to be associated with more severe disease from respiratory viruses,” he added.

Studying other coronavirus outbreaks provides further suggestions that smokers may fare worse with these types of viral infections than non-smokers. In a study of a small number of patients with Middle-East Respiratory Syndrome (MERS) in South Korea, patients who smoked were less likely to survive than those who did not. There was also some evidence that smokers had higher levels of a protein called DPP4, a receptor which allows the MERS coronavirus to enter cells in the lung, which could make their lung cells more susceptible to attack from the virus. SARS-CoV2, the coronavirus responsible for the current outbreak, uses a different receptor to gain access to lung cells called ACE2. However, the news here isn’t any better for smokers either.

“The ACE2 receptor is up-regulated in the respiratory cells of smokers. This might be a mechanism by which it is more likely to cause severe illness,” said Hays.

There are also other, well-proven reasons for smokers to be concerned about their risk of severe or fatal COVID-19.

“There is a long history of smokers having more severe respiratory illness in general and this is for a few well-established reasons. They clear mucus less efficiently, the cilia which get infectious particles and secretions out of the lungs, work less efficiently. Smoking also causes inflammation in the airways, which is made worse with respiratory illnesses,” said Hays.

So if you are reading this and you smoke or know someone who does, is it too late now to stop or cut down?

“People who quit for even a short time see an improvement in lung health quite quickly. For most smokers who don’t already have serious lung injury, they will see immediate improvements in their health, and less opportunity for severe diseases including COVID-19,” said Hays.

In 2015, the CDC reported that almost 7 out of 10 adult smokers wanted to try and quit, with over half of all of them trying to quit at least once in that year, but the large majority not succeeding. Is it likely that people will try to quit, and succeed, especially at such a stressful time for many?

“I understand people turn to things because it’s a coping mechanism, especially at stressful times. I would say to them – try and flex other coping muscles, there is a real opportunity to break routines – even a short period of abstinence from smoking improves lung function,” said Hays.

“People could look at this as an opportunity – a time of crisis is a time of opportunity. If you’ve been looking for an opportunity to quit, this is it,” he added.