E-cigarettes popularity forces firms to review policies

November 11, 2013

ecigar

When John Castellano feels like a smoke, he simply heads to the break room at Kraft Foods’s factory in Garland, Texas.

The technician has been able to indulge his habit in common areas at work since he started using electronic cigarettes, which emit vapor rather than smoke.

E-cigarettes are “very liberating,” said Castellano, 39, who used to join the other cigarette addicts at the factory’s designated smoking area.

Twenty-five years after companies began banning smoking in the workplace, the increasing popularity of e-cigarettes is forcing them to review their policies.

Many corporations still ban “vaping” as they wait to see if the FDA will regulate e-cigarettes as strictly as regular smokes. Yet Kraft and Walgreen allow local managers to set the rules. Smaller firms, especially creative agencies and Web startups, have already adopted a more laissez-faire attitude.

US e-cigarettes sales will triple this year to $1.5 billion, according to Euromonitor International. They’re expected to accelerate as traditional tobacco makers muscle into a market previously dominated by small players.

Both Altria Group and Reynolds American, the biggest US tobacco sellers, are expanding distribution of e-cigarettes. Lorillard controls about half of the USmarket with blu eCigs, which it acquired last year.

So far, small companies where bosses can monitor whether e-cigarettes bother co-workers are more likely to allow vaping.

“It is all new to us,” said Ged King, president of the Sales Factory, a 35-employee marketing firm based here. He looked up in surprise during a staff meeting a few months ago to see an employee vaping. Now several employees do it, presumably “to help them kick the smoking habit,” he said.

“We’ve not put a policy in place because nobody has complained,” King said.

The technology gives users seeking anonymity an edge. E-cigarettes heat liquid nicotine into an inhaled vapor, dissipating faster than cigarette smoke. So workers more worried about being seen than smelled puff e-cigarettes in empty offices and bathrooms, according to posts on the E-Cigarette Forum website, where visitors share favorite flavors and vaping lounges, plus tips on how to avoid offending co-workers.

“I’m doing it on the down-low and just close the door,” said Dennis Rumpf, a construction manager in Charlotte, N.C. He declined to identify his employer because it didn’t authorize him to speak publicly.

Rumpf, 37, said he alternates between menthol and classic tobacco flavors in the e-cigarettes he’s been using for six months, after 19 years as a smoker.

“I have people come into my office all the time and I’m sure they’d say something if they noticed anything,” he said.

Web developer Adam Gray has won his boss’s approval to use e-cigarettes at his Minnetonka, Minnesota, office.

“It makes him more productive and sets him on a path for better health,” said Paul Hanson, chief operating officer of TrackIF LLC, a firm that monitors price changes across the Web.

Gray, 27, can “vape all day, a puff here and there” without leaving his desk, he said.

Kraft doesn’t have a companywide e-cigarettes policy and allows managers to make their own rules as long as they abide by local and state laws. Walgreen, the largest US drugstore retailer, also leaves decisions to office managers.

However, health and regulatory uncertainties have prompted many employers to treat e-cigarettes like regular cigarettes, said Paula Andersen, a registered nurse at Buck Consultants, a human- resources firm that advises companies on health programs.

“We recommend that if companies do have a tobacco-free policy that they call electronic cigarettes out as well,” said Andersen, who declined to identify clients.

Exxon Mobil and General Motors allow vaping in designated smoking areas, while CVS Caremark and Lowe’s ban e-cigarettes and regular smokes. Levi Strauss & Co. forces vapers to go outside.

“For the most part, people who vape are treated as smokers,” said LeeAnn Blohm, who favors chocolate peanut butter and butterscotch e-cigarettes. She declined to identify her employer in Austin, Texas, which doesn’t allow vaping inside.

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Agencies
June 28,2020

As the COVID-19 wave sweeps strongly across the country, including in Tamil Nadu, mental health experts say the pandemic has triggered panic attacks among those who tested positive for the virus, causing bouts of depression and even driving some to the brink of suicide.

According to experts, nervousness, fear of contamination, panic attacks, constant reassurance seeking behaviour, sleep disturbance, excessive worry, feelings of helplessness and probability of an economic slowdown are the major factors leading to depression and anxiety among the people.

Potential job losses, financial burden, uncertainty about the future and fears of running out of food and necessities add to the worries.

Online platforms too have seen a growing number of people seeking help for mental health issues, ranging from anxiety and loneliness to concerns over productivity and job loss since the outbreak of COVID-19.

Director of Institute of Mental Health here, Dr R Purna Chandrika said towards April end about 3,632 calls were received and psychiatric counselling was provided to 2,603 callers.

"We have dedicated services at our centres in the districts and the calls meant for government medical college hospitals are routed to the respective institutions," she said.

Due to heavy virus caseloads, making this city the major contributor to the state's tally, the Greater Chennai Corporation too started a free helpline to help residents cope up with stress during the pandemic.

"From the psychological perspective, we don't find a single human being who is not feeling some degree of stress or anxiety due to coronavirus. The intensity and impact varies from person to person," said Lt Col N T Rajan, director of Chennai-based Mastermind Foundation.

The organisation is involved in free counselling throughout India ever since the first case of the deadly virus was reported in the country.

The foundation's recommendation on not to deploy the vulnerable in the police force, especially those above 50 years and women personnel with children below five years for COVID-19 related duty, was accepted and implemented by the Punjab government.

Psychiatrists feel that further worsening situations could lead to severe mental health issues, even triggering suicidal tendencies.

"Further worsening depression may lead to severe mental health issues and suicidal tendencies," said Dr S Senthil Kumar, a psychiatrist.

However, not all of them require medicines, he added.

"The situation is serious. There should be counselling at three stages--on coping with the virus, how to face it if tested positive and how to face life once treated and discharged from the hospital," Rajan said.

Awareness was of paramount importance, he said and warned the pandemic could cause panic attacks while in hospital or drive them to the brink of suicide.

Tamil Nadu, one of the worst affected states with a virus count in excess of 74,000 as of Friday, has witnessed a few instances of suicides allegedly related to COVID-19.

Hari Singh, owner of popular 'Iruttu Kadai' halwa shop in Tirunelveli, allegedly died by committing suicide on Thursday after being tested positive for COVID-19. He was 80.

Earlier in May, two COVID-19 patients in their 50s allegedly committed suicide in separate instances, at the government hospitals they were admitted to for treatment.

In the city corporation limits, a three-member team comprising a psychiatrist, counsellor and a social worker work for the respective zones.

"We direct certain sections of people like those with withdrawal symptoms and people requiring pills, to visit the doctor at their corporation zonal at a specific time, for medicines," a health worker of the civic body said.

Health platform, Lybrate reported an increase of 180 per cent in online patient consultations related to mental health on its platform between March 1 and June 20 across the country.

The largest increase came from Mumbai and Delhi, followed by Pune, Ahmedabad, Chennai and Bengaluru.

The biggest jump was witnessed in the age group of 25 and 45 years.

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Agencies
May 26,2020

Tedros Adhanom Ghebreyesus, the World Health Organisation's (WHO) Director-General, said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to "a temporary pause", while the safety data of the the anti-malaria drug was being reviewed.

According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalized, reports Xinhua news agency.

The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate.

"The Executive Group of the Solidarity Trial, representing 10 of the participating countries, met on Saturday (May 23) and has agreed to review a comprehensive analysis and critical appraisal of all evidence available globally," Tedros said in a virtual press conference on Monday.

The review will consider data collected so far in the Solidarity Trial and in particular robust randomized available data, to adequately evaluate the potential benefits and harms from this drug, he said.

"The Executive Group has implemented a temporary pause of the HCQ arm within the Solidarity Trial while the safety data is reviewed by the Data Safety Monitoring Board. The other arms of the trial are continuing," Tedros added.

WHO initiated the Solidarity Trial, a plan to evaluate the safety and efficacy of four drugs and drug combinations against COVID-19 more than two months ago, which include HCQ.

According to the WHO, over 400 hospitals in 35 countries are actively recruiting patients and nearly 3,500 patients have been enrolled from 17 countries under the Solidarity Trial.

Tedros added that the safety concern over the drug related only to the use of HCQ and chloroquine in COVID-19, and "these drugs are accepted as generally safe for use in patients with autoimmune diseases or malaria".

"WHO will provide further updates as we know more," he added.

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Agencies
May 14,2020

COVID-19 mostly kills through an overreaction of the immune system, whose function is precisely to fight infections, say scientists who have decoded the mechanisms, symptoms, and diagnosis of the disease caused by the SARS-Cov-2 coronavirus.

In a study published in the journal Frontiers in Public Health, the researchers explained step-by-step how the virus infects the airways, multiplies inside cells, and in severe cases causes the immune defences to overshoot with a "cytokine storm".

This storm is an over-activation of white blood cells, which release too-great amounts of cytokines -- inflammation-stimulating molecules --into the blood, they said.

"Similar to what happens after infection with SARS and MERS, data show that patients with severe COVID-19 may have a cytokine storm syndrome," said study author Daishun Liu, Professor at Zunyi Medical University in China.

"The rapidly increased cytokines attract an excess of immune cells such as lymphocytes and neutrophils, resulting in an infiltration of these cells into lung tissue and thus cause lung injury," Liu said.

The researchers explained that the cytokine storm ultimately causes high fever, excessive leakiness of blood vessels, and blood clotting inside the body.

It also causes extremely low blood pressure, lack of oxygen and excess acidity of the blood, and build-up of fluids in the lungs, they said.

The researchers noted that white blood cells are misdirected to attack and inflame even healthy tissue, leading to failure of the lungs, heart, liver, intestines, kidneys, and genitals.

This multiple organ dysfunction syndrome (MODS) may worsen and shutdown the lungs, a condition called acute respiratory distress syndrome, (ARDS), they said.

This, the researchers explained, happens due to the formation of a so-called hyaline membrane -- composed of debris of proteins and dead cells -- lining the lungs, which makes absorption of oxygen difficult.

Most deaths due to COVID-19 are therefore due to respiratory failure, they said.

The researchers explained that in the absence of a specific antiviral cure for COVID-19, the goal of treatment must be to the fight the symptoms, and lowering the mortality rate through intensive maintenance of organ function.

For example, an artificial liver blood purification system or renal replacement therapy can be used to filter the blood through mechanical means, they said.

The team noted that especially important are methods to supplement or replace lung function, for example with non-invasive mechanical ventilation through a mask, ventilation through a tube into the windpipe, the administration of heated and humidified oxygen via a tube in the nose, or a heart-lung bypass.

The researchers stressed the importance of preventing secondary infections.

They noted that SARS-Cov-2 also invades the intestines, where it causes inflammation and leakiness of the gut lining, allowing the opportunistic entry of other disease-causing microorganisms.

The researchers advocate that this should be prevented with nutritional support, for example with probiotics -- beneficial bacteria that protect against the establishment of harmful ones -- and nutrients and amino acids to improve the immune defences and function of the intestine.

"Because treatment for now relies on aggressive treatment of symptoms, preventative protection against secondary infections, such as bacteria and fungi, is particularly important to support organ function, especially in the heart, kidneys, and liver, to try and avoid further deterioration of their condition," Liu added.

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