CONTENTS:

Tobacco News

Smokefree law has saved 40,000 lives
Smokefree England – One year on
Majority of licensees support smokefree law

Parliamentary News

EDM 1890 & 1904 Proposals for tobacco sales by small retailers
PQ: Smoking and Young People

Industry Watch

Altria drops new filter cigarettes strategy
Sexy packs – the art of promoting tobacco via eye-catching cigarette pack design

Recent Research

Effect of tobacco displays at point of sale
Tobacco smoke exposure does not increase breast cancer risk

Events and Publications

See List of Events at the end of this bulletin

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Tobacco News

Smokefree law has saved 40,000 lives

The nationwide smoking ban has triggered the biggest fall in smoking ever seen in England, according to new research.

More than two billion fewer cigarettes were smoked and 400,000 people quit the habit since the ban was introduced a year ago, which researchers say will prevent 40,000 deaths over the next 10 years.

Smoking was outlawed in all enclosed public spaces in England, including pubs and restaurants, on 1 July 2007. Similar bans were introduced in Scotland on 26 March 2006 and in Wales on 2 April 2007.

Doctors said they were astonished by the numbers quitting. Robert West, director of tobacco studies at the Health Behaviour Research Unit, University College London, who carried out the study, said: "These figures show the largest fall in the number of smokers on record. The effect has been as large in all social groups – poor as well as rich. I never expected such a dramatic impact." There was no guarantee that smoking rates would not start to rise again, after falling, and it was crucial to maintain the downward pressure, Professor West said. Currently around 22 per cent of the adult population smoke in Britain.

"If the Department of Health can keep up the momentum this has created, there is a realistic prospect of achieving a target of less than 15 per cent of the population smoking within 10 years," he said.

The survey of 32,000 people in England interviewed before and after the ban took effect found the decline in smoking had accelerated. In the nine months before the ban it fell 1.6 per cent compared with 5.5 per cent in the nine months after the ban. Researchers estimate on the basis of these figures that 400,000 people quit smoking as a result of the ban.

The study, by Cancer Research UK and its partners, is the first in the world to examine the impact of a smoking ban in isolation from other tobacco control measures.

Cigarette sales fell by 6 per cent in the past year, according to the market research company, Neilson. In the 10 months from July 2007 to the end of April 2008, 1.93 billion fewer cigarettes were sold in England and 220,000 fewer in Scotland (where the smoking ban was introduced a year earlier), equivalent to a total decline in sales over the full year of 2.6 billion.

Jake Shepherd, the marketing director at Neilson, said smoking had been hit by a triple whammy, which accounted for the dramatic effect.

"In addition to the smoking ban, sales have been hit by the outlawing of the sale of tobacco to under-18s and the increase of duty on tobacco, which is pricing cash-strapped smokers out of the market," he said.

A survey of 1,000 people with lung conditions by the British Lung Foundation found more than half said they had suffered fewer attacks of breathlessness from exposure to smokers in pubs and restaurants, and more than a third said it had helped keep them out of hospital.

Dame Helena Shovelton, the foundation's chief executive, said: The smoking ban has helped to save the lives of people with breathing problems by cutting down their exposure to passive smoke. People with smoking-related lung conditions know how devastating it is to be struggling for breath. A smoke-free atmosphere gives our lungs a new lease of life."

The Independent, 30 June 2008
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/smoking-ban-has-saved-40000-lives-856885.html

Widespread support for smokefree law

Most people continue to support the UK-wide smoking ban, reveals a report published today by the Office for National Statistics (ONS). Eighty per cent of respondents taking part in the 2007 Omnibus Survey said they agreed with the legislation banning smoking in enclosed public places. Sixty one per cent strongly agreed and 19 per cent agreed. A further 14 per cent disagreed with 6 per cent disagreeing strongly.

Almost three quarters of people tend to visit the pub as often as they did before the smoking ban (73 per cent) with 16 per cent reporting that they now go more often. The remaining 11 per cent said they went less often than before the smoking ban. Those in employment were also less likely to experience smoking in the workplace. Ninety-three per cent said that smoking was banned in the building where they worked. In particular 31 per cent reported that no smoking was allowed on the premises or the grounds where they worked.

There has also been a drop in the number of people allowing smoking in their home. Approximately two-thirds (67 per cent) said that smoking was not allowed at all in their home compared to 61 per cent in 2006. Awareness of the effects of second-hand smoking was widespread. Respondents thought that a child’s risk of getting chest infections (91 per cent) and asthma (85 per cent) were increased by living with a smoker. Seventy-nine per cent of smokers said they did not smoke at all when they were in a room with a child and 13 per cent said they would smoke fewer cigarettes in the presence of a child. Nearly all (94 per cent) of respondents agreed there should be smoking restrictions in place where there are, or are likely to be, children under the age of 16.

The awareness of the effect of second-hand smoke on adults increased in 2007 compared to previous years. More than 80 per cent thought that second-hand smoking would increase a non-smoking adult’s risk of lung cancer, bronchitis and asthma.

The findings are reported in the 12th survey of smoking behaviour and attitudes, carried out by ONS for the NHS Information Centre for health and social care.

Source: Office for National Statistics News Release, 18 June 2008
Smoking related behaviour and attitudes 2007. ONS, 2008. http://www.statistics.gov.uk/pdfdir/smoke0608.pdf

Majority of licensees support smokefree law

Despite the majority of licensees losing cash because of the smoking ban, a poll has found that more and more are supporting the measure.

The 1,500 licensees quizzed by CGA Strategy were asked if they still supported the smoking ban. Sixty four per cent answered yes - an increase of seven per cent from the 57 per cent who said they supported the ban from the start.

Nearly half of respondents – 48 per cent – said they ‘strongly’ supported the ban.

Tony Payne, chief executive of the Federation of Licensed Victuallers’ Associations, said he was not surprised by the level of support shown.
He said: “We saw the same thing in Ireland. After people got over the initial problems it was seen as the best thing that ever happened.”

The survey also revealed that 65 per cent of licensees would not overturn the ban if they had the power to do so. The other 35 per cent said licensees should have the power to make the decision and that if they did they would allow smoking.

Paul Smith, executive director of Noctis which represents late-night operators, said: “There are plenty of people who saw the ban as an opportunity as well as those who saw it as a threat. Like most bans it was generally seen as unpopular at first but now it is here people are working with it.”

Andy Brooks, licensee of the Laughing Fish in Isfield, East Sussex said that the ban has benefited his business. “Because we serve good quality food there is no question that people who would not come here before the ban are now considering the pub as a place to eat. The ban has most definitely had a positive impact and I think to go back would be a retrograde step.”

Chris Maclean, licensee of The Railway Hotel, in Faversham, Kent, added: “We have all had to do it and the reality is that it was not as damaging as first suggested. In fact the reality is that it is much nicer to run a pub without smoking.”

Source: The Publican, 26 June 2008
Link: http://tinyurl.com/5oxmbu

Parliamentary News

EDM 1890 Proposals for tobacco sales by small retailers

Roger Godsiff MP has placed the following EDM:

That this House applauds the hard work of small retailers across the country; praises the vital role they play in diverse communities; acknowledges that they face many economic and commercial pressures threatening their viability and survival; is concerned that the regulatory burden placed upon them should be maintained at an appropriate level; expresses its concern that any new proposed measures to restrict the display of tobacco products in small shops should be balanced, proportionate and firmly evidence-based; calls on the Government to commit to open, full and genuine consultation with all affected and interested parties to examine the impact of such proposals on the viability of small shops, the market in illicit tobacco and the impact on competition; welcomes Government action to address illegal sales of tobacco to under-18s; thanks the retail trade for the sometimes difficult role it plays in enforcing this measure; and encourages the Government to continue to pursue the most effective, evidence-based measures by which under-18s can be deterred and prevented from smoking.

25 June 2008

A separate, similarly worded EDM has been put down by Jim Dobbin MP.
EDM 1904 Small shops and restrictions on point of sale displays of tobacco products.
http://edmi.parliament.uk/EDMi/EDMDetails.aspx?EDMID=36225&SESSION=891

PQ: Smoking and Young People

David Crausby: To ask the Secretary of State for Health what steps he plans to take to reduce levels of smoking among teenagers.

Dawn Primarolo (Minister of State (Public Health): Reducing smoking among young people is a priority for the Government. Much has already been achieved in this area, including increasing the age of sale of tobacco products, legislation to strengthen sanctions available against retailers who persistently sell tobacco to children and young people. Smoking is also address in the national curriculum through the Healthy Schools Programme.

Protecting children and young people from smoking is one of four key aspects of the Department's "Consultation on the future of tobacco control" published on 31 May 2008. Responses to the consultation will inform the development of a new strategy on tobacco control, which will include action to continue to tackle the uptake of smoking by young people.

Hansard Source - 24 June 2008, Column 209W
http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080624/text/80624w0011.htm#080624109002710

Industry Watch

Altria drops new filter cigarettes strategy

To generate growth, Philip Morris has been developing reduced-risk products -- so far without much success.

Marlboro Ultra Smooth was the product of a top-secret Philip Morris project internally code-named SCOR, or Smoke Constituent Reduction, and
included an activated carbon filter that delivers nicotine but with potentially less exposure to the carcinogens of conventional cigarettes.

Other failures include the Accord, which uses a battery-powered holder to primarily heat, rather than burn, tobacco. Deemed too strange for U.S. smokers to embrace, it was discontinued in 2006 after nearly a decade of consumer research.

In January, Philip Morris withdrew a so-called smokeless product, Taboka Tobaccopaks. The "spit-free" product is tobacco in small pouches known as snus (rhymes with "goose") placed between cheek and gum. The company continues to test Marlboro Snus.

It has also been working on moist snuff, a category that has been growing overall. A market test of Marlboro Moist Smokeless Tobacco, begun in Atlanta in October, was recently expanded to surrounding counties. But Philip Morris has had to slash the price of the product sometimes known as "Marlboro in a can," sometimes to as little as $1 a tin, down from the hoped-for $3.

Wall Street Journal, 23 June 2008
http://online.wsj.com/article/SB121418691547195835.html?mod=googlenews_wsj

Sexy packs – the art of promoting tobacco via eye-catching cigarette pack design

In an article about cigarette pack design, the industry trade journal Tobacco Reporter candidly explains why tobacco packaging is so important to the industry:

“Everyone in the industry is looking for the next latest and greatest innovations as the bar is raised higher and higher for cigarette packs. All the focus on advertising and marketing is now turned to the pack, as restrictions abound and the pack remains the one avenue of communication with the consumer.” The article adds that: “Today’s packs are certainly turning heads with glitz and glamour – flashy foils, fancy paperboard featuring unique curves, and etching and embossing that you just have to touch.”

Tobacco Reporter, March 2008

Recent Research

Effect of tobacco displays at point of sale

Displaying tobacco in wall units at convenience stores and other retail outlets has an unhealthy influence on children and people trying to quit smoking, according to research conducted in New Zealand.

Lead researcher Dr George Thomson, of Otago University , said tobacco companies paid retailers to keep the wall displays up because they worked.

"In essence, they normalise smoking."

Calls for the removal of the displays had already met opposition, particularly from 24 hour convenience store owners who have claimed a ban would have a serious effect on business.

However the study published in the New Zealand Medical Journal indicated that in countries that had imposed a ban on tobacco "power walls", there was little financial effect on retailers.

Professor Janet Hoek and Dr Heather Gifford, two of the study co-researchers, said interviews with former smokers and lapsed quitters showed that tobacco displays tempted people struggling to give up the habit.

"Despite the ban on tobacco advertising, wall displays are de facto advertising in over 5000 retail outlets across the country," the researchers said.

The study also found evidence that displays influenced children, increased impulse purchasing, and were crucial to tobacco marketing.

The Government is currently analysing submissions on proposals to further restrict or ban tobacco displays in retail settings.

The research was partly funded by the Cancer Society and ASH New Zealand.

Source: Evidence and arguments on tobacco retail displays: marketing an addictive drug to children? Yahoo, 20 June 2008

Thomson G et al. New Zealand Medical Journal, 20-June-2008, Vol 121 No 1276
http://www.nzma.org.nz/

Tobacco smoke exposure does not increase breast cancer risk

Exposure to tobacco smoke during childhood or as an adult does not increase the risk for developing breast cancer among women who have never smoked, a large prospective study has shown.

The researchers claim that previous positive findings from retrospective studies suggesting such a link have been distorted by the fact that women were more likely to report past exposures because they knew that they had breast cancer.

A recent collaborative analysis of 53 epidemiological studies found that cigarette smoking had little or no independent effect on the risk of women developing breast cancer, note Kirstin Pirie and colleagues from the University of Oxford in the UK.

Furthermore, in 2004, the International Agency for Research on Cancer endorsed the "lack of carcinogenicity of tobacco smoking in humans for cancers of the female breast."

It has been suggested, however, that passive smoke exposure might increase breast cancer among those who have never smoked - based largely on the findings reported from 14 epidemiologic studies.

Noting potential bias in the design of these studies, the researchers investigated passive smoking in 224,917 never smokers aged an average of 58 years who enrolled in The Million Women Study between 1996 and 2001.

Women were asked if their parents had smoked when they were born and when they were 10 years old, and also if they were currently living with a partner who smoked.

As reported in the International Journal of Epidemiology, women who were exposed to passive smoke as children were at no greater risk for developing breast cancer than those who were not exposed (adjusted relative risk [RR]=0.98), nor were women who were exposed as adults (RR=1.02).

Results did not vary with regard to parity, alcohol consumption, body mass index, age at menarche, age at first birth, whether or not the woman worked, use of oral contraceptives, or use of hormone replacement therapy.

The authors acknowledge that some previous studies have demonstrated a potential interaction between smoke exposure and N-acetyltransferase 2 genotype variants. However, they say larger studies such as the present one are needed to confirm any link.

MedWire News June 20, 2008

Pirie K, Beral V, Peto R, Roddam A, Reeves G, Green J; for the Million Women Study Collaborators. Passive smoking and breast cancer in never smokers: prospective study and meta-analysis. Int J Epidemiol. 2008 Jun 10. [Epub ahead of print] http://ije.oxfordjournals.org/

Events and Publications

Events

5 July – RCP Public Open Day to celebrate 60th anniversary of the NHS
Admission free. Includes information on medical education and training, guided tours of the building, and the history of medicine. Open 11am – 40pm.
Details: www.rcplondon.ac.uk

1-4 October – 11th European Health Forum Gastein: Theme - Values in Health: from vision to reality
Venue: Bad Hofgastein, Salzburg, Austria
Details: www.ehfg.org

2 October 2008 – BASSP 2nd conference
The British Association for Stop Smoking Practitioners (BASSP) – 2nd Conference
The focus for this one day event will be smoking and mental health and how to collect and analyse data from your service.
Venue: Manchester University
Details: Contact Louise Preston for more details about contributing to the conference: lapreston@ntlworld.com or visit website: www.brit-thoracic.org.uk/bassp

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

27-29 October - SCTRP three-day course, Central London
Contact Janice Rossabi, SCTRP Course Secretary at sctrp@yahoo.co.uk

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

2009
8-12 March - World Conference on Tobacco and Health
Venue: Mumbai, India
Details: www.14wctoh.org