CONTENTS:

Tobacco News

NICE guidance on smoking cessation
Fall in cigarette sales after smoking ban
EC: SCENIHR opinion on smokeless tobacco products

Parliamentary News

PQ Tobacco Smuggling
EDM – No Smoking Day

Industry Watch

BAT position on combating smuggling
BAT wins bid for Turkish tobacco company, Tekel

Recent Research

Smoking status of step-parents as a risk factor for smoking in adolescence
School nurses’ role in adolescent smoking cessation

Events and Publications

See List of Events at the end of this bulletin

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Tobacco News

NICE guidance on smoking cessation

NICE has published guidance on the best way to encourage people to stop smoking. This is the first fully comprehensive guidance on smoking cessation issued by NICE to ensure that stop smoking services are as effective as possible. The guidance is aimed at all professionals who have a direct or indirect role in helping people to quit smoking, including PCTs, local authorities and community and voluntary sectors.

NICE recommendations include:

• PCTs, SHAs and commissioners should set minimum realistic targets for their local populations with an aim to treat at least 5% of their population who smoke each year and to aim for a success rate of at least 35% at 4 weeks

• NHS Stop Smoking Services should target minority ethnic and socio-economically disadvantaged communities in the local population

• NRT, varenicline or bupropion are recommended as treatment options for people who are planning to stop smoking on or before a particular date (target stop date) and alongside proven behavioural counselling and group therapy

• Varenicline or bupropion should not be offered to young people under 18 or to pregnant or breastfeeding women

• Personalised information, advice and support should be offered to pregnant women on how to stop smoking

• Young people aged 12–17 should be offered information, advice and support on how to stop smoking. NRT may be used for young people over 12 years who show clear evidence of nicotine dependence and as part of a supervised regime.

NICE press release, 27 Feb 2008

The summary and full guidance is available at: http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11925

Fall in cigarette sales after smoking ban

The decline in sales of tobacco following last summer’s ban on smoking in public places is accelerating, according to new figures. In the 12 months to the end of January 2008, the number of cigarettes sold fell almost 4% to 47 billion, according to market research company Nielsen, compared with a decline of 2% in the 12 months to 6 October. The number of cigarettes sold in the three months following the ban was down 6.3% compared to the same period the previous year. In the final 3 months of 2007, the sales slump gathered pace with volumes down 6.7% year-on-year. This was in marked contrast to the first six months of 2007 when sales declined by just 0.1%.
Despite the fall in sales, price rises pushed the value of tobacco sold up 2.3% to £9.68 billion.

The Grocer, 25 Feb 2008

EC: SCENIHR opinion on smokeless tobacco products

In its 22nd plenary meeting on 6 February 2008 the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) adopted its opinion on smokeless tobacco products, concluding that they are addictive and hazardous to health. Furthermore, the Committee examined the role of these products in smoking initiation and cessation, as well as the possibility to extrapolate the experience and use patterns from countries permitting the use of oral tobacco to other EU Member States, where this use is currently banned.

According to the opinion, which was published on 18 February 2008 after a public consultation, smokeless tobacco is addictive and withdrawal symptoms are broadly similar to those seen in smokers. Smokeless tobacco products contain various levels of toxic substances and these products are carcinogenic to humans. The Committee also stated that on the available evidence it is not possible to draw conclusions as to the relative effectiveness of smokeless tobacco as an aid to smoking cessation in comparison with established therapies.

Source: Health & Consumer e-News, 18 February 2008
http://ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_013.pdf

Parliamentary News

PQ Tobacco Smuggling

David Taylor: To ask the Chancellor of the Exchequer
(1) what the major brands of smuggled hand-rolled tobacco seized were in each of the last five years for which data is available;

(2) what proportion, by weight, of the smuggled hand-rolling tobacco seized was (a) industry manufactured and (b) counterfeit in each of the last five years for which data is available;

(3) what estimate he has made of the proportion of the smuggled UK cigarette market made up of counterfeit brands in each of the last five years for which data is available.

Angela Eagle: In each of the last five years, the major brands of hand-rolling tobacco seized by HMRC have been Cutters Choice, Drum, Golden Virginia, Old Holborn, Raw, Samson and The Turner.

From 2003-05 HMRC seizures of hand-rolling tobacco over 100kgs were analysed, of which approximately 87 per cent. by weight was industry manufactured and 13 per cent. was counterfeit.

From October 2006 to December 2007, HMRC seizures of hand-rolling tobacco over 50 kgs were analysed, of which approximately 86 per cent. by weight was industry manufactured and 14 per cent. was counterfeit.

Although HMRC do not routinely estimate the counterfeit share of the illicit cigarette market, they do publish in HMRC's annual report their own analysis of the provenance of large cigarette seizures (individual seizures in excess of 100,000 sticks). This information explains the proportion of such seizures found to be counterfeit and the principal non-counterfeit brands seized.

7 Feb 2008 : Column 1372W

EDM 991 - NO SMOKING DAY

The following EDM has been laid by Dr Ian Gibson:

That this House congratulates the No Smoking Day charity on its 25th annual public health campaign, The Great No Smoking Day Challenge, which will take place on 12th March 2008; further notes that despite recent tobacco control legislation smoking remains the number one cause of premature avoidable death in the UK; and further notes the need for continued support of No Smoking Day, local stop smoking services and other projects aimed at helping smokers who want to quit.

Industry Watch

BAT position on combating smuggling

The following is an extract from a speech by Michael Prideaux, BAT’s Director, Corporate and Regulatory Affairs, at a recent international conference on ‘Counterfeiting, piracy and illicit trade’:

“We estimate that the size of the global illicit trade in cigarettes to be approximately 390 billion sticks annually representing 6% of total world cigarette consumption. This denies governments approximately US$20 billion in annual revenue.

The temptation of smuggled product in terms of pricing is naturally high, and smugglers themselves make enormous profits by taking advantage of the fact that cigarette duties are high. The high value to volume ratio of cigarettes, ease of production and movement, low detection rates and penalties, make cigarettes an attractive addition to organised crime’s portfolio of activities.

For example, if they were to buy a 40 foot container of cigarettes in China and sell this in the UK at $6 per pack, they would make a margin of US$2.5 million per container. There is a lot at stake.

In addition to the loss to government revenue from counterfeit and smuggled cigarettes, we believe illicit trade bleeds our bottom line by no less than US$ 650 million annually, making us one of the most significant victims of illicit trade in the world.

We are interested in exploring with governments the viability of track and trace systems to secure the supply chain. We don't think there's a one-size-fits-all approach to this but stand ready to embrace better systems which make sure that legitimate product gets to legitimate retail outlets.

We applaud the efforts of the WHO and the governments taking part in tackling the issue of illicit trade [at the FCTC illicit trade meeting] in such a comprehensive manner which will be a precedent for other sectors. This is, indeed, an excellent example of capacity building and cooperation between governments, civil society and industry on an international scale.

Among the more encouraging proposals on the table are plans to target criminals and their assets more effectively. The protocol also calls for more deterrent penalties on counterfeiters.

However, we remain particularly concerned by provisions in the FCTC encouraging governments to increase duties on cigarettes. While the public policy objectives are laudable in theory, in practice, we have found that higher duties directly result in dramatic levels of smuggling which in turn completely undermine these objectives.

There needs to be a balance between health and tax policy to ensure that illicit trade levels remain in check. With greater smuggling, the cost of cigarettes actually decreases, thereby making cigarettes even more accessible to the public. We see this in markets all over the world and it's a reality we grapple with every day.

We respect the World Health Organisation and its goals. We do hope, however, that policy makers involved in the talks will appreciate the realities of the market and balance their proposals with stronger support for a substantially greater allocation of resources for enforcement and capacity building at all levels. This is indeed an area we are happy to help them with.”

BAT Press Office, February 25, 2008

BAT wins bid for Turkish tobacco company, Tekel

British American Tobacco has strengthened its presence in Turkey, the world's eighth-largest tobacco market, by winning the auction for Tekel Cigarette, the state-owned cigarette maker.

The maker of Lucky Strikes emerged victorious with a $1.72bn bid after its rivals - Citigroup Ventures, Cinven and Dogan, a Turkish media and consumer goods conglomerate - bowed out during the process.

The Turkish cigarette market is dominated by Philip Morris, the US group, which has 40 per cent of the market. If successful, the transaction will lift BAT's share of the Turkish market from 7 per cent to 36 per cent.

Like its competitors, BAT has sought to build sales in emerging markets as tobacco consumption in western European markets decline after governments banned smoking in public places.

About half of BAT's revenues and pre-tax profits come from emerging markets.

Tekel employs about 15,000 people, but its operations are loss-making. Last year, it reported a loss of nearly TL 340m ($283m) on sales of TL916m.

Nonetheless, Paul Adams, BAT’s chief executive, said he expected the deal to become earnings enhancing from 2009, as improvements in the supply chain and savings in administrative costs feed into the company's overall results.

Mr Adams said this would come in spite of an expected 5 per cent decline in the Turkish market as a public smoking ban is implemented over the next 18 months.

"We are buying into a declining asset," he said. "But the fall in volume will be compensated by the growing population, better pricing and consumers trading up."

The Turkish government is seeking to reduce the incidence of smoking in an attempt to reduce the cost of cancer treatment on the cash-strapped health service. New anti-smoking legislation was approved last month and is due to come into effect between April 2007 and October 2008.

The Financial Times, 25 February 2008

Recent Research

Smoking status of step-parents as a risk factor for smoking in adolescence

Abstract

Aim: To examine the extent to which smoking by step-parents and biological parents predicts adolescent smoking.

Design: Five-year cohort study.

Setting: Thirty-six schools in South London, England.

Measurements: Students reported their smoking status, which was cotinine-verified, as well as whether their parents smoked and, if they lived with a step-parent, whether that step-parent smoked. Analyses also controlled for gender, ethnicity and deprivation.

Findings: Students who reported that just their step-parent smoked at age 11-12 were significantly more likely to report current smoking at any time-point from age 11-16 than those who reported having neither biological parents nor a step-parent who smoked [odds ratio (OR) 2.72, 95% confidence interval (CI) = 1.36-5.47], as were those with both a parent and a step-parent who smoked (OR 2.23, 95% CI = 1.46-3.41.) While the association between smoking in students and smoking in biological parents in this subsample did not reach statistical significance (OR 1.39, 95% CI = 0.88-2.19), these students were no more or less likely to smoke than those with just a step-parent who smoked.

Conclusion: Smoking by a non-biological parent appears at least as influential as smoking by biological parents. This confirms the importance of social influence on smoking initiation and suggests that attempts to work with parents in smoking prevention should involve, and perhaps pay particular attention to, step-parents who smoke.

Fidler, JA et al Smoking status of step-parents as a risk factor for smoking in adolescence. Addiction, Volume 103, Number 3, March 2008 , pp. 496-501(6)

http://www.ingentaconnect.com/content/bsc/add/2008/00000103/00000003/art00023

School nurses’ role in adolescent smoking cessation

Abstract

School nurses who work with adolescents are in an ideal position to promote smoking cessation. This opportunity is important because research suggests teens who smoke are likely to become habitual smokers. This study characterizes adolescents' patterns and levels of smoking, describes adolescents' perceptions toward smoking, and delineates quit strategies that may prove helpful for adolescents who attempt smoking cessation. Results suggest adolescent smokers have highly variable patterns and levels of smoking. They fail to consider their future health and continue to be unaware of the harmful effects of smoking and the addictive nature of tobacco. Among adolescent smokers, there are few gender differences in perception of smoking. Therefore, gender specific cessation programs may not be necessary. The most effective quit strategy was the acquisition of information on contents of cigarettes and the health effects of smoking. Armed with these strategies, school nurses can provide leadership in the design and implementation of school based smoking cessation programs.

Fritz DJ et al. Program strategies for adolescent smoking cessation.
Sch Nurs. 2008 Feb;24(1):21-7.
http://nasn.allenpress.com/nasnonline/?request=get-abstract&issn=1059-8405&volume=24&page=21

Events and Publications

Events

10th - 12th March 2008 SCTRP three-day course, Central London
This Course is the development of the traditional 'Maudsley Training'. It focuses on treatment methods validated by research. It also covers aspects of the smoking cessation field useful for policy-makers and public health practitioners.
Contact Janice Rossabi, SCTRP Course Secretary at sctrp@yahoo.co.uk

12 March – Budget

1-2 April 2008 – 16th UKPHA Annual Public Health Forum
Venue: Liverpool.. See: www.ukphaconference.org.uk for more details.

28-29 April 2008 - A Call To Action: Successful Tobacco Control for the Future
Conference organised by ASH Wales. http://www.smoking-conference-wales.org.uk/

16-18 April – SCTRP three-day course, Central London

30 June – 1 July 2008 – UK National Smoking Cessation Conference (UKNSCC)
Venue: Hilton Birmingham Metropole Hotel
The world’s largest gathering of smoking cessation practitioners, researchers and policy makers.
Abstract deadline: 14 April 2008. See www.uknscc.org for more information.

4-8 October 2008 – European Respiratory Society Annual Congress
Details: info@ersnet.org

27-29 October - SCTRP three-day course, Central London

5 December - Annual Update and Supervision Day
The annual Update and Supervision Day is the opportunity for graduates of the SCTRP Courses to ‘calibrate’ their clinical practice and share information in this fast-developing field. The programme consists of talks on new developments in treatment theory and practice, practical sessions on treatment details, and discussions of participants’ experience. As well as supervision and troubleshooting sessions, the Update provides an opportunity for networking among 100 clinicians and service co-ordinators.
For further details please contact Janice Rossabi, SCTRP Course Secretary at sctrp@yahoo.co.uk