Scotland: Smokers to be banned from fostering and adopting by councils

Councils in Scotland are pushing ahead with plans to ban smokers from fostering or adopting babies and young children, raising fears it may become more difficult to find them loving homes.

Authorities in Falkirk, Stirling and Clackmannanshire hope the proposed policy will protect the under-fives and other vulnerable young people from the harmful effects of passive smoking, which include increased risk of cot death, pneumonia, bronchitis, asthma and ear diseases.

The number of children needing placements in foster and care homes or with adoptive parents in Falkirk has risen from 172 in August 2006 to 244 in August 2008.

Falkirk Council will decide its policy next Tuesday. If it is passed, smokers will be banned from adopting or fostering any child under five or those with a disability or respiratory problems, asthma or heart disease.

The policy also rules that children from non-smoking families should not be placed with families who smoke.

All older children who are able to express a view must be given a choice about being placed with a smoking family.

Falkirk has around 80 young people who need to be found foster or adoptive parents, and opinions are divided between foster carers and health campaigners as to whether the plans intrude on personal freedoms and may deter prospective parents from coming forward.

The move comes after a blanket ban on smokers becoming foster carers was passed this week in the London borough of Redbridge.

Margaret Anderson, head of services for children and families at Falkirk Council, said many Scottish councils were taking similar measures.

She told The Scotsman: "We are making these recommendations because of the very strong advice from the British Association for Adoption and Fostering and the Fostering Network that this is best practice."

She said many issues had to be taken into consideration, but in her experience few foster parents or prospective parents were smokers.

Health bodies are backing the council's stance. Gordon Brown, public affairs manager for Asthma UK Scotland, said: "A child's welfare should be paramount when taking any decision which affects their health, and for those with asthma the effects of smoking can be deadly.

"It can increase the risk of an asthma attack, permanently damage someone's airways and block the benefit of some asthma medicines.

"We know that children whose parents smoke are 1.5 times more likely to develop asthma and we consider it vitally important to reduce this risk to children."

Childcare agencies have pointed out that councils find themselves in very difficult positions.

Maggie Mellon, a spokeswoman for Children 1st Scotland, warned that by focusing on parents, the council could be seen to be judging adults rather than protecting children.

She said: "You can be a smoker and a good parent, the thing is not to inflict the smoking on the child.

"What is the lesser of two evils – a child stuck in a care home or a loving parent who commits to never smoking in the house?

"A middle road would be to get the parent to guarantee not to smoke in the house.

"But where do you draw the line? Councils have a statutory duty of care to the child and are probably worried about being sued years down the line, after a foster carer allowed a child to smoke who subsequently developed health problems."

Source: The Scotsman, 07 November 2008
Link: http://tinyurl.com/5sszu6

Taiwan: Legislative Yuan urged to pass cigarette surcharge bill

The John Tung Foundation is calling for an amendment to the Tobacco Hazards Prevention and Control Act, which would raise the "welfare surcharge" on cigarettes from the current NT$10 (US$0.30) to NT$20 per pack in a bid to discourage smoking.

"An increase in the price of cigarettes and the creation of a tobacco-free environment are expected to lead to a decrease in the consumption of cigarettes," said Lin Ching-li, director of the foundation's tobacco control division.

According to the World Health Organization, non-smoking environments and high tobacco prices are the two most effective measures to reduce tobacco consumption and smoking among young people.

Rebutting some tobacco companies' claim that increasing the price of cigarettes would result in rampant smuggling, the foundation insisted that this did not happen in the past when Taiwan increased the surcharge on cigarettes.

Taiwan first imposed what it called a welfare surcharge of NT$5 per pack on cigarettes in 2000, and in 2006 doubled the amount, with the revenues being used to fund social services programs.

Nonetheless, Lin noted, the price of cigarettes in Taiwan remains relatively low compared to other places. In Hong Kong, the average price of a pack of cigarettes is NT$125 and in New York it is NT$280, she said.

She said that in 1983 Hong Kong authorities began to increase tobacco taxes, which resulted in a drop in the smoking rate from 23 percent in 1982 to 14 percent in 2005.

Considering the average income of Taiwan citizens, the price of a pack of cigarette should range between NT$80-NT$100, instead of the current average NT$60, she suggested.

The Executive Yuan in late October approved an amendment to the Tobacco Hazards Prevention and Control Act to increase the welfare surcharge on cigarettes from NT$10 to NT$20 per pack. The amendment is currently awaiting review and approval by the Legislative Yuan.

Other new regulations in the act, which will go into effect Jan. 11 next year, will expand non-smoking areas in schools, medical and financial institutions, government units, restaurants, transport stations and shopping centres.

A 1999 World Bank report stated that when the price of tobacco is raised by 10 percent, consumption decreases by 4 to 8 percent, and even by as much as 10 percent among youngsters, the anti-smoking foundation said.

Most of the revenues from the welfare surcharge is put into social services, including the National Health Insurance, which is suffering a serious deficit.

According to statistics compiled by the Department of Health, about 23 percent of Taiwan's population are smokers.

Source: Taiwan News, 09 November 2008
Link: http://tinyurl.com/5r5vey

Impulsive behaviour more common among children of smokers

A new study conducted by researchers at Nationwide Children's Hospital found that adolescents with parents who smoke may also share a tendency to act impulsively, a trait that could be linked to a decision to become a smoker. The study, due to be published in the January issue of Drug and Alcohol Dependence may help identify behavioural risk factors for adolescent smoking - risk factors that could increase some teens' chance of addiction even before they pick up their first cigarette 

Brady Reynolds, PhD, the study's lead author and principal investigator with the Center for Biobehavioral Health of The Research Institute at Nationwide Children's Hospital, has focused much of his work on the connection between smoking and impulsivity, or more specifically, delay discounting. Delay discounting describes a person's preference for a smaller, more immediate reward over a larger reward that is delayed for a period of time. It also has been shown to play an important role in the behaviour of cigarette smoking.

Reynolds found that cigarette smoking mothers chose the immediate reward (discounted) significantly more than nonsmoking mothers. Similarly, children of mothers who smoked discounted significantly more than children of nonsmokers. These results parallel findings between adult addicted and non-addicted populations.

"Based on our findings, campaigns to prevent adolescents from smoking are likely to be more effective if they emphasise short-term consequences to smoking, as opposed to long-term consequences," said Reynolds, also a member of the faculty at The Ohio State University College of Medicine. "This strategy would seem to be especially important for those adolescents most at risk of nicotine addiction."

The study examined 60 participants in the central Ohio community and included half of the mothers who reported currently smoking, and the other half reported never smoking. All of the children (12-13-years-old) were nonsmokers.

Reynolds added, "Our study is significant in that it indicates most adolescent smokers, or children at risk of smoking, respond to more immediate consequences when making choices. Therefore, prevention programs that stress the long-term negative effects of smoking are going to be less effective for those adolescents most at risk of smoking. Also, cessation programs focused on long-term outcomes will likely be less effective for adolescent smokers attempting to quit."

Source: Medical News Today, 07 November 2008
Link: http://tinyurl.com/6f6wk4

Therapy helps some smokers give up after heart attack

Cognitive behavioral therapy (CBT) appears to help people who are depressed after suffering a heart attack to avoid smoking cigarettes, but only if they believe they have adequate social support, new research shows.

The findings suggest that most smokers will need more than CBT alone to give up the habit after a heart attack, but they also underscore the value of this therapy in treating depression in people with heart disease, Dr. Mickey Trockel of the Stanford University School of Medicine and colleagues report.

After a heart attack, smokers can substantially reduce their risk of dying if they quit, the researchers note in their study, published in the journal Psychosomatic Medicine. But people with heart disease frequently suffer from depression, which can make kicking the habit more difficult.

In the current study, the researchers looked at whether CBT had any effect on smoking behaviour in 1,233 patients who had a heart attack and were participating in a trial investigating the effect of CBT on depression and low perceived social support. Study participants were randomly assigned to undergo at least six sessions of individual therapy or usual care.

Twelve percent of the study participants didn't report smoking at the study's outset, but picked up the habit again later on.

Overall, the researchers found, patients who had CBT were no less likely to report smoking than those who didn't receive therapy. But when they limited their analysis to patients who believed they had adequate levels of social support, therapy cut their likelihood of smoking by 32 percent.

"Our findings suggest CBT may have little effect in reducing smoking behavior among a larger population of smokers outside a smoking cessation program," Trockel and colleagues conclude. "More focused smoking cessation intervention is needed."

Nevertheless, they add, the fact that the study wasn't specifically designed to look at how CBT affected smoking behavior but did find a "beneficial side effect" of the treatment on smoking, "adds more support for the use of CBT, a well established evidence-based therapy, for the treatment of depression" among heart attack patients.

Source: Yahoo News, 07 November 2008
Link: http://tinyurl.com/5w7vjl

Canada falls short on tobacco control: report

Canada is failing to meet key obligations of an international treaty on tobacco control, according to a report by health advocacy groups.

Canada does not demand health warnings on all tobacco products, has not done enough to control tobacco advertising, and has all but ignored the problems of smoking on native reserves, the report says.

All are measures that are required under the World Health Organization's Framework Convention on Tobacco Control.

The WHO treaty, which has more than 160 signatories including Canada, came into force in February, 2005. A meeting will be held in Durban, South Africa, later this month to measure its effectiveness.

But according to a report by the coalition of Canadian health groups, which calls itself the Global Tobacco Control Forum, this country's efforts have been mixed at best.

"The challenge has been getting the machinery of government, beyond the bureaucracy, to engage on the issue," said Cynthia Callard, the executive director of Physicians for a Smoke-Free Canada, one of the coalition members.

Countries that signed the treaty promised to make health warning labels cover at least 30 per cent of all tobacco-product packages.

In Canada, the report says, the warnings are not required on the flavoured cigarillos favoured by young people because the more stringent regulations apply only to cigarettes - and cigarillos are not technically cigarettes.

The Conservative government has promised to prohibit the flavours that make the cigarillos appealing to children and to ban advertising that is likely to be viewed by young people, steps which Ms. Callard applauds.

But, she says, Ottawa has been aware of the loophole for years and did not move to close it.

The treaty also says countries must ban advertising or, if the constitution of a country prevents the ads from being banned, they must contain health warnings.

Cigarette ads reappeared in Canada last November after a Supreme Court ruling allowed tobacco companies to advertise in print. But there is no federal law that forces them to contain health warnings, the report says.

The treaty also decried the high levels of smoking among indigenous peoples. Canada has turned a blind eye to tobacco use on reserves, Ms. Callard said.

"On first nations territories, there is virtually no protection from secondhand smoke, there is virtually no monitoring of sales to youths or advertising or promotion at retail," she said.

"What I don't accept is that we should let the situation continue that way and that we should let people die of tobacco-caused disease because we don't want to have a confrontation."

A spokeswoman for federal Health Minister Leona Aglukkaq said in an e-mail yesterday that Ottawa understands the importance of meeting the commitments outlined in the treaty.

Josée Bellemare said, "Our government recognizes that tobacco is a major health issue and is committed to curbing tobacco use as well as complying with its obligations under the Framework Convention on Tobacco Control."

Source: Globe and Mail, 07 November 2008
Link: http://tinyurl.com/55r8zk