The United States has dramatically changed overall smoking habits by legislation that restricts advertisements and areas where patients can smoke and also by high taxation of tobacco products. George A. Kaplan, PhD. We will cover some of the subjects a little bit earlier, Australia now requires plain packaging on tobacco products and France consumers in the same room. What do you think is the most effective way to curb tobacco use. What can be done from the social and epidemiologist's point of view? Dr. Anton Titov, MD. The most effective way to curb tobacco smoking is to eliminate cigarettes. George A. Kaplan, PhD. I could stop there. But I won't. George A. Kaplan, PhD. We know that is not going to happen. Unlikely, highly unlikely. There is too much money being made. It is not just American countries. It is American companies. It is British American Tobacco and a variety of others who have built the cigarette factories in China. Not so Russia and Russia. Okay, so this is a global company. Local phenomena we have to do have to have lots of strategies and the strategies will involve. These are borne out, by epidemiological evidence and by sociological and political science evidence. The strategies involve environmental restrictions on where you can smoke there even apartment houses and in California in Northern California where I live. George A. Kaplan, PhD. That will not allow you to smoke in your apartment because tobacco smoke gets into other apartments. Certainly, pricing taxation makes it more expensive and. Don't allow the sale of individual cigarettes. There are also changing the image of smoking through culture through advertising, changing the culture. Smoking. George A. Kaplan, PhD. That will affect initiation smoking a lot, okay. Dr. Anton Titov, MD. You still have are going to have patients who are heavy smokers. They are going to need special Special interventions that probably involve nicotine replacement and a variety of other things. Then there is the big question right now, about e-cigarettes. George A. Kaplan, PhD. We don't know enough yet. But we do know that nicotine is not a neutral, nontoxic substance, even if you are not inhaling stuff into the lungs. Sometimes you are getting that nicotine in, through other mechanisms. George A. Kaplan, PhD. That has cardiovascular effects, it has metabolic effects and has lots of other effects. It is not a benign medication in any way. George A. Kaplan, PhD. We don't know enough yet to know how serious the problem of E-cigarettes is going to be from a health perspective. But certainly, they are being marketed heavily. It is seen as a big branding opportunity for a lot of backhoe companies. We have to watch that very carefully because, in all likelihood. George A. Kaplan, PhD. That may just replace one poison with another
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