ASH Daily News for 30 April 2010
HEADLINES
- Scotland: Scheme to help pregnant women stop smoking ‘a success’
- Children of women who smoked during pregnancy 'more likely to be obese as teenagers'
- llicit tobacco trade booms in Ireland
- Australia: Big tobacco to fight Rudd's cigarette plain packaging plan
- Cigarette smoking, fructose consumption exacerbates liver disease, study finds
- Tobacco firms take aim at Bangladeshi, Asian women
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Scotland: Scheme to help pregnant women stop smoking ‘a success’
A scheme to help pregnant women stop smoking could be extended to the rest of Scotland after a successful trial in Tayside.
First Minister Alex Salmond told MSPs yesterday that the project – which involves people being paid not to buy cigarettes – had produced positive results.
Participants in the Give it Up for Baby scheme are tested weekly at a local pharmacy to confirm their tobacco-free status.
If they manage to stay off cigarettes, a store card is credited with a maximum of £12.50 a week which can be used to buy groceries and baby goods at selected supermarkets.
Some 135 women in Angus, 125 in Perth and Kinross and 164 in Dundee have signed up to the scheme, which also offers nicotine-replacement therapy and social support.
Smoking can contribute to low birth weight and premature deliveries.
NHS Tayside public-health consultant official Andrew Radley said the project, which started in April 2007, had been very successful, with 18% of women staying smoke-free three months after having given birth. Mr Salmond told the Scottish Parliament ministers were now considering how the scheme could be “rolled out” across the country.
He said health board funding for smoking-cessation programmes had increased from £27million in 2005-2008 to £40million in 2008-2011. But, despite the best efforts of the NHS, pregnant women still found it difficult to quit smoking. Mr Salmond added: “We do continue to do all that we can to encourage them to make healthier lifestyle choices, both for their own sake and for their unborn child.”
Earlier this year, MSPs approved legislation to ban the display of cigarettes and tobacco in shops and outlaw cigarette vending machines, to make smoking less attractive to children.
The ban on tobacco displays will come into force for large retailers such as supermarkets next year.
Corner shops have until 2013 to make the necessary arrangements to keep tobacco out of sight.
Earlier this week, a three-month consultation was launched. It gives retailers the chance to comment on how the restrictions will be implemented in stores.
Source: The Press and Journal - 30 April 2010
Link: http://bit.ly/aLmX9r -
Children of women who smoked during pregnancy 'more likely to be obese as teenagers'
The children of women who smoked while pregnant are more likely to be obese in their teenage years, a study has revealed.
Researchers found that those who were exposed to cigarette smoke while in the womb had significantly higher quantities of fat than their non-exposed peers later in life.
The exposed teenagers had a third more fat around their internal organs and 26 per cent more fat directly under the skin, according to the international team that carried out the study.
Zdenka Pausova, one of the study's two principal investigators, said the findings provide another reason for expectant mothers to avoid smoking.
She said: 'We believe that maternal cigarette smoking during pregnancy plays an important role in the foetal programming of obesity.'Although we do not know the exact mechanisms, we know that nicotine in cigarette smoke, for example, sets into the baby's body and stays there in higher quantities and for longer than in the mother's.
'Animal studies suggest that nicotine given prenatally could influence certain parts of the brain, including those that control how much and what we eat and how well we burn calories.'
The scientists studied more than 500 teenagers between the ages of 12 and 18, half of whom were exposed to maternal cigarette smoke.
Those who were exposed weighed about 300 grams less at birth than their peers, were breast-fed for a shorter period of time and were exposed more frequently to second-hand smoke in-utero.
Magnetic resonance imaging was used to measure the two types of fat and the teenagers were interviewed by a nutritionist to track their daily energy and nutrient intake and asked to complete questionnaires about their physical activity.
Dr Pausova said: 'We found that in late puberty, there was quite a profound difference in adiposity (the accumulation of fat).'
She said this was important as obesity related disorders usually considered diseases of adulthood are now beginning in adolescence.
This is thought to be the first study to find that in-utero exposure to cigarette smoke is associated with higher intra-abdominal fat in late puberty.
The research, carried out by scientists from the University of Nottingham and four Canadian universities, is published in the latest edition of the journal Obesity.
Source: Daily Mail - 30 April 2010
Link: http://bit.ly/caPNVW -
llicit tobacco trade booms in Ireland
The trade in illicit tobacco has reached new heights in the Republic of Ireland, creating more problems for the nation's recession-hit independent retailers.
One store owner from Temple Bar in Dublin told C-Store that his turnover had plummeted from £25,000 a week to £15,000 in the past 12 months as illicit traders adopted crafty new ways of selling cheap counterfeit cigarettes.
Handwritten notes offering counterfeit versions of top-selling brands for little more than half the legitimate price are being widely dropped through letter boxes. C-Store saw scribbled notes offering 200 JPS Blue cigarettes for just 45 Euros more than 40 Euros cheaper than the legitimate price.
There are also widespread reports of illicit traders targeting people who leave their contact numbers in the classified sections of local papers.
A Centra retailer from Cork said he was aware of cartons of 200 cigarettes being sold for 20 Euros through his local pub.
Maired Warren, manager of O Reilly's Garage in Cork, said the problem had worsened noticeably since a ban on the display of legitimate tobacco was enforced in shops last summer. "Before it was mainly cigarette sales that were being affected, but roll your own is now a problem, too," she said.
"While the legitimate channel is being forced to comply with a mountain of regulation, very little is being done to combat the illicit trade, making it an attractive option for criminals," she added.
Anti-smoking group ASH Ireland also said that more needed to be done to control the problem. "Customs and Excise needs additional services to tackle this epidemic or it will expand rapidly," a spokesman warned. "Additional personnel, technology, canine support and legislative changes are needed urgently."
Source: The Grocer - 29 April 2010
Link: http://bit.ly/a4qvfl -
Australia: Big tobacco to fight Rudd's cigarette plain packaging plan
Outraged tobacco companies have blasted Kevin Rudd's new cigarette packaging plans, threatening to challenge them in court and seek compensation.
Earlier today the Prime Minister announced the tax on cigarettes would increase by 25 per cent from midnight tonight and that tobacco companies would be required to use plain packaging from July 1, 2012.
Mr Rudd said he went public with the plan because of Australian Tax Office reports that revealed smokers, fearing a price rise, had begun stockpiling cigarettes.
The moves have been welcomed by health advocates but tobacco companies are arguing the new packaging plan will damage their brand name and some already have plans to take legal action.
“Introducing plain packaging just takes away the ability of a consumer to identify our brand from another brand and that's of value to us,” Imperial Tobacco Australia spokeswoman Cathie Keogh told ABC Radio.
She added the company was planning legal action.
British American Tobacco Australia told The Australian Online: “We oppose plain packaging and we will defend the intellectual property which lies in that packaging.
“If that requires us to take legal action, then we would do so.
“We would look at various things, including intellectual property rights, trademark legislation and remedies under international treaties.”
BATA would also consider pursuing compensation from the government for “acquisition of our property on unjust terms”.
Retailers have also said the tax hike would hurt their businesses and agreed with tobacco companies that plain packaging would bolster the cigarette black market.
“It's a lazy policy response being pushed by some health advocates,” said Mick Daly, chairman of Australian supermarket chain IGA.
“That amounts to a direct attack on approximately 16 per cent of Australians who have made legal and legitimate lifestyle choices.”
The Australian Newsagents' Federation said the move would hurt punters who buy smokes and affect the budget bottom line of newsagencies.
Chief executive Alf Maccioni said he thought the government was indulging in a greedy tax grab rather than taking action because of genuine health concerns about cigarettes.
“It would appear that the proposed increase in tobacco excise is not motivated by health concerns but rather is an unfair and excessive tax grab.”
But the head of the government's preventative health taskforce said there would be one million fewer smokers by 2020 if measures such as plain cigarette packets were implemented.
And Professor Rob Moodie said he did not believe tobacco companies would be entitled to compensation.
“It's a solid case on constitutional and legal grounds,” he said, rejecting suggestions easy-to-copy plain packets would be a boon for dodgy cigarette counterfeiters.
Mr Rudd said that revenue from the hike in the tobacco excise would generate an extra $5 billion over four years and would be directly invested in hospitals.
Announcing the rise himself in Sydney's Commonwealth Parliamentary Offices, the Prime Minister said it would not lift the government in the popularity stakes.
“This is a tough decision for the government,” he said. “It won't win the government any popularity. The big tobacco companies will hate what we are doing.
“It is the right decision.”
The tax hike means the price of a pack of 30 cigarettes will increase by about $2.16
The government believes the changes will cut tobacco consumption by 6 per cent and the number of smokers by 2 or 3 per cent - totalling roughly 87,000 Australian smokers.
Internet advertising of cigarettes will also be restricted, and an extra $27.8 million will be spent on anti-smoking campaigns.
Health Minister Nicola Roxon said 15,000 people a year were dying from tobacco-related illnesses. When she was a young child her father, who smoked, died from cancer of the oesophagus
“If our action today can mean that any other child has their parents with them for a little longer, that'll be a good thing. And we don't make any apologies about taking this action,” she said.
Despite announcing a series of policy backdowns through other government ministers in recent weeks, Mr Rudd delivered today's “tough decision” on cigarettes personally.
Last week junior ministers Greg Combet and Kate Ellis were charged with walking away from the government's commitment to resume its home insulation scheme and its promise to end the “double drop-off” for parents by building another 222 childcare centres.
Also last week Attorney-General Robert McClelland dropped a proposal for a human rights charter, claiming it was too politically divisive.
Three weeks ago the suspension on Sri Lankan and Afghan asylum-seeker claims was announced by the Immigration Minister Chris Evans, Foreign Minister Stephen Smith and Home Affairs Minister Brendan O'Connor.
Opposition health spokesman Peter Dutton earlier today supported an increase in the tobacco excise but questioned the timing of the cigarette packaging announcement by the Rudd government.
He argued it was a deliberate attempt to shift attention away from the government's recent policy backflips, including yesterday's delaying of the emissions trading scheme.
Source: The Australian - 29 April 2010
Link: http://bit.ly/biuU9i -
Cigarette smoking, fructose consumption exacerbates liver disease, study finds
Recent studies suggest that modifiable risk factors such as cigarette smoking and fructose consumption can worsen nonalcoholic fatty liver disease (NAFLD). With NAFLD, fat accumulates in the liver of overweight individuals despite drinking little alcohol, causing in some cases liver scarring that can lead to liver failure. Identifying modifiable factors that contribute to disease severity and progression is essential in improving patient outcomes.
Details of these studies are published in the May issue of Hepatology, a journal of the American Association for the Study of Liver Diseases (AASLD).
NAFLD is the most common cause of liver disease worldwide and research suggests the number of cases will climb given an increasing trend toward higher fat diets, obesity, decreased physical activity, and a rise in diabetes. Past studies indicate that more than 30 million Americans have NAFLD and approximately 8 million may have nonalcoholic steatohepatitis (NASH).
In the first study, Ramón Bataller, M.D., and colleagues from the Hospital Clínic in Barcelona, Spain investigated the effects of cigarette smoking (CS) in obese rats. Rats were divided into 4 groups (n=12 per group): obese smokers, obese non-smokers, control smokers and control non-smokers. Smoker rats were exposed to 2 cigarettes/day, 5 days/week for 4 weeks. Researchers found that obese rats exposed to CS showed a significant increase in ALT serum levels (indicating liver disease), while this effect was not observed in control rats.
"Our results show that CS causes oxidative stress and worsens the severity of NAFLD in obese rats," said Dr. Bataller. "Further studies should investigate longer exposures to CS, and assess whether this finding also occurs in patients with obesity and NAFLD."
In her editorial, also published in Hepatology this month, Claudia Zein, M.D., from the Cleveland Clinic, noted that "the importance of these results is that taken together with other experimental and clinical data, they support that cigarette smoking appears to aggravate liver injury in patients with liver disease." Dr. Zein added, "Studies characterizing the effects of cigarette smoking in human NAFLD will be crucial because of the vast number of patients that may benefit from modification of this risk factor."
Additionally, prior studies suggest an over consumption of high fructose corn syrup (HFCS), primarily in the form of soft-drinks, have contributed to weight gain and the rise in obesity, particularly in children and adolescents. Table sugar (sucrose) and HFCS are the two major dietary sources of fructose. Over the past 40 years, consumption of dietary fructose has increased 1,000% according to Bray et al, and doctors believe it to be a major cause of NAFLD.
Researchers from Duke University studied 341 adults enrolled in the NASH Clinical Research Network who responded to a Block food questionnaire within 3 months of a liver biopsy. Fructose consumption was estimated conservatively by including that found in beverages, which accounts for 50% of dietary fructose intake. Results showed that 27.9% of participants consumed at least 1 fructose-containing beverage per day, 52.5% had 1 to 6 beverages with fructose per week, and 19.7% drank no beverages with fructose.
"In patients with NAFLD, daily fructose ingestion was associated with reduced fatty liver (steatosis), but we found increased fibrosis," noted Manal Abdelmalek, M.D., M.P.H, and lead author of the study. "Further dietary intervention studies are needed to evaluate whether a low-fructose diet improves metabolic disturbances associated with NAFLD and improves patient outcomes for those at risk of disease progression," concluded Dr. Abdelmalek.
A second fructose study led by Ling-Dong Kong, M.D., from Nanjing University in China investigated the effects of curcumin on fructose-induced hypertriglyceridemia and fatty liver in rats. Curcumin, a compound derived from turmeric (curcuma root), is sold as an herbal supplement and is believed to have anti-inflammatory, anti-tumor, and anti-viral properties. Researchers observed a hyperactivity of hepatic protein tyrosine phosphatase 1B (PTP1B), which is associated with defective insulin and leptin signaling, in fructose-fed rats.
For the first time this study demonstrated that curcumin inhibited hepatic PTP1B expression and activity in fructose-fed rats. "Our results provide novel insights into the potential therapeutic mechanisms of curcumin on fructose-induced hepatic steatosis associated with insulin and leptin resistance," said Dr. Kong.
These studies indicate modifying risks such as smoking and fructose consumption offer potential benefits for those with liver diseases. Further studies are needed to explore these benefits in preventing the progression of liver disease.
Source: Science Daily - 27 April 2010
Link: http://bit.ly/deWBEF -
Tobacco firms take aim at Bangladeshi, Asian women
Bangladeshi chest doctor Kazi Saifuddin Bennoor has seen many misleading cigarette advertisements, but the one that suggested smoking could make childbirth easier plumbed new depths.
Advertisements telling smokers they are smarter, more energetic and better lovers than their non-smoking counterparts are a familiar sight across Bangladesh -- something unimaginable in most other countries.
One in a rural area, Bennoor remembers, said that "if a lady smokes, her baby will be smaller and it will be easier to deliver, the labour will be less painful".
"These are very ruthless advertisements," said Saifuddin, an associate professor at Bangladesh's National Hospital for Chest Diseases.
The promotion is being linked to an alarming rise in tobacco use in the impoverished South Asian country, particularly among women and the young -- a trend repeated across many developing countries, anti-tobacco groups say.
The World Health Organisation warns that tobacco companies are targeting women in developing countries as a new growth market and Dhaka-based doctors treating lung diseases report they are seeing more female patients.
Around 28 percent of adult Bangladeshi women now use tobacco, according to the latest WHO survey, and 43 percent of the adult population -- or 41 million people -- use tobacco in some form, up from 37 percent in 2004.
"(Tobacco use) has become an epidemic among rural women. It's a very serious health issue," a government advisor on health, Syed Mudasser Ali, told AFP, adding that anti-smoking laws were poorly enforced.
Tobacco advertising was banned in Bangladesh in 2005, so the advertisements are usually fly-posters that do not specify the company behind the message.
"Only a negligible number of people have been fined for breaching tobacco laws over the last few years," Ali said.
Officially 57,000 people die in Bangladesh of tobacco use annually, but that figure was likely a "huge underestimate".
The country fits a pattern emerging across the region of rising rates of female tobacco use, particularly in Southeast Asian countries such as Indonesia, the Philippines and Cambodia.
This rise is largely because more Asian women are entering the workforce, have disposable income and see smoking as "modern and liberated," said doctor Mary Assunta, director of the International Tobacco Control Project.
"I've seen tobacco companies' marketing campaigns on my university campus and in residential dormitories," said one 25-year-old Bangladeshi female smoker who used to smoke a pack a day but is trying to quit on her doctor's advice.
"They approach students with a questionnaire and ask them to fill it in to win T-shirts or lighters," she said, adding that she started smoking as her friends in class at Dhaka University all smoked.
Tobacco companies are encouraging the trend, viewing women in developing countries as their "largest unexploited market", according to the WHO -- which has chosen the theme of tobacco marketing to women for 2010 No Tobacco Day on May 31.
"We see clear marketing strategies targeting women in Asia such as lipstick-type cigarette packs in Indonesia, Malaysia and Laos," said Assunta.
The pretty, small packets of ultra-thin cigarettes are designed to be something a woman would like to carry around with her at all times, just like her favourite lipstick.
"These fit easily into women’s purses. Cigarette packs are coloured pink and there are even fruit flavoured cigarettes," Assunta said.
Tobacco companies in Bangladesh contacted by AFP all denied using illegal fly-posters or point of sales marketing, which the ministry of health hoped to stop with an amended version of the 2005 law.
The market is dominated by volume leader Dhaka Tobacco, which has a 40-percent share and monopolises low-end sales.
British American Tobacco, which makes the popular Pall Mall and John Player Gold Leaf cigarettes, dominates the 140 million dollar premium tobacco market with its Benson and Hedges brand.
"BAT Bangladesh markets cigarettes in Bangladesh in full compliance of all applicable laws, rules, and regulations," company spokesman Shamim Zahedy told AFP, adding that their marketing only targeted existing smokers.
In February, WHO chief Margaret Chan said that developing countries were the "new frontier" for tobacco marketing.
"If Big Tobacco is in retreat in some parts of the world, it is on the march in others," she said in a speech on the fifth anniversary of an international convention on tobacco control.
"In these countries as elsewhere, girls and women are a market with attractive and lucrative growth potential, and they are likewise being targeted," Chan said.
In developed countries, tobacco companies have seen their marketing restricted or banned and sales are falling as public health campaigns and tight rules on smoking in public places hit profits.
As a result, developing markets are becoming "increasingly important" for transnational companies such as BAT and Philip Morris International -- which is aggressively expanding in the Philippines and Indonesia, said Assunta.
"Tobacco companies are definitely putting effort into consolidating their positions in low income countries," she said.
Even Bangladesh, where nearly 40 percent of the population of 144 million lives on less than a dollar a day, is a lucrative tobacco market, with annual sales estimated at around one billion dollars.
In Bangladesh's remote, rural areas, the health risks of tobacco use are not always well known, Bennoor said, making poor farmers -- particularly women who are generally less well educated -- an easy target.
"It is a vicious cycle: people who are poor are more vulnerable to tobacco addiction, and then they are smoking, and it makes them poorer," he said.
For Bangladesh's rural poor, approximately 4.5 percent of household expenditure goes on tobacco, according to WHO estimates.
In some areas, there have been signs of a fightback against the advertising, however.
At Dhaka University, one fly-poster claiming "smoking makes you smarter and more manly" prompted a student-run counter-campaign.
"We are smart and we don't smoke," said handmade posters plastered over the original adverts on the university's city-center campus.
Source: My Sinchew - 29 April 2010
Link: http://bit.ly/aZMXIk
