HEADLINES

• Doctors happily cite alcohol as cause of death, but not smoking
• Economies splutter, but tobacco is in rude health
• USA: Health officials wary of dissolvable tobacco
• Qatar to move ahead with bid to curb smoking
• Blood test could identify smokers at higher risk for heart disease

• Doctors happily cite alcohol as cause of death, but not smoking

  UK doctors are willing to cite alcohol as a cause of death on death certificates, but not smoking, for fear of stigmatising the deceased, shows research published online in the Journal of Clinical Pathology.

  This has implications for the true extent of the impact of smoking on health, say the researchers, who point out that the current statistical estimates of the death toll from smoking are potentially flawed.

  They looked at just over 2,000 death certificates and 236 post mortem reports, issued at a large London teaching hospital between 2003 and 2009, to see what cause of death doctors had cited.

  Doctors have been allowed to cite smoking and alcohol as a direct or underlying cause of death without the need to refer the case to a coroner since 1992.
  Smoking was identified as the cause of death in only two certificates (0.1% of the total) and included in part II of the death certificate, which outlines other contributory conditions, in only 10 cases (0.5% of the total).

  The two cases in which smoking was cited were lung cancer and chronic obstructive pulmonary disease (COPD). Yet 279 deaths included these diagnoses, and in most cases the deceased was a current (over 45%) or former (over 23%) smoker. It is well known that smoking is the primary cause of both lung cancer and COPD.

  In all, 407 deaths were caused by conditions in which smoking is thought to have a substantial role. Yet smoking was cited as the cause of death in only two of these certificates and as a contributory factor in six.

  The post mortem reports were no better: not a single case cited smoking as causing or contributing to death, which the authors describe as "surprising."

  Yet doctors willingly cited alcohol as a direct or contributory cause of death. This was cited in over half (57.4%) of the 54 death certificates, which included diagnoses linked to alcohol use.

  "Death certification is an important source of mortality data and directly captures 99.79% of all deaths in the UK," say the authors, who point out that the doctors in this study are not unique in their reluctance to cite smoking as a cause of death.

  "There are many reasons why smoking is not cited as a [cause of death] by doctors in the UK," they write. "The first and frequently debated reason relates to doctors' desire not to cause relatives distress by stigmatising the deceased and their smoking habit."

  "Given the overwhelming evidence showing a causal link between smoking and certain terminal conditions, more effort should be made to record smoking on the death certificate. It is clear that the current arrangements fail to achieve this," they conclude.

  Source: Science Daily , 24 Oct. 2011
  Link: http://bit.ly/tyGjpM

• Economies splutter, but tobacco is in rude health

  Financial markets continue to exhibit volatility, with large share price reactions to both positive and negative news.

  The tobacco sector has been one sector that has benefited from the uncertainty, as investors look to more defensive areas. Imperial Tobacco and British American Tobacco are the UK’s two main players in this sector. The companies have global exposure through various cigarette brands, to suit smokers’ spending power. They have seen strong absolute returns due to better than anticipated earnings numbers and secure and high dividend yields, which have appealed to investors keen to avoid excessive risk.

  Tobacco companies have also benefited from emerging market growth, as not only are smoking rates high but more people in these regions are taking up the habit and the population is expected to continue to increase.

  The world cigarette market accounts for around six trillion cigarettes globally each year, with China accounting for around a third of total global consumption.

  Tobacco companies hope that as the mature Western markets decline, due to increasing regulation, health warnings and an increase in smoking bans in public places, consumption will increase in emerging markets to offset this.
   

  Source: nebusiness.co.uk, 24 Oct 2011
  Link: http://bit.ly/tzQhQv

• USA: Health officials wary of dissolvable tobacco

  Health officials in Colorado are preparing for a fresh tobacco assault they feel sure is about to happen, if it hasn’t started already.

  
  In May, R.J. Reynolds Tobacco introduced its new “dissolvable” products into Colorado as a test market. Those products include Camel Orbs, Camel sticks, twisted sticks the size of a toothpick; and Camel strips, similar to breath strips. All are made from finely ground menthol-flavoured tobacco and are designed to melt in the mouth.

  Tobacco is tobacco, even if it is smokeless, and it’s illegal for vendors to sell the products to minors. It’s also a violation of the state’s Tobacco-Free Schools Act for students to bring these items onto their campuses. Indeed, as far as state officials know, no Colorado student has yet been caught sneaking a tobacco orb, strip or stick into his or her mouth at school.

  But health officials feel it’s just a matter of time, given the allure of the product.

  “They only started testing this product in Colorado a few months ago. We haven’t had time to track its usage,” said Bob Doyle, executive director of the Colorado Tobacco Education and Prevention Alliance, a state-wide coalition of organizations committed to reducing tobacco use. “But we’re trying to get ahead of this before it happens.”

  Last month, the Colorado Board of Health unanimously approved a resolution calling on RJ Reynolds to stop the test marketing of the candy-like products in the state until the federal Food and Drug Administration decides whether to regulate them or not. The FDA will report to Congress next March the results of its study of the health effects of dissolvable tobacco.

  
  Meanwhile, Doyle is urging all schools to provide fact sheets about dissolvable tobacco to staff and parents, and to monitor whether the products have appeared on their campuses. If so, he’d like to know.

  
  “We have research that shows that youth smokers are very brand loyal,” Walton said. “We know that Camel is one of the most popular brands with teen smokers, so anything marketed under the Camel brand will appeal to young people. We have a study that shows established youth smokers are most likely to smoke the same brand as the first cigarette they tried. So if they’ve tried a Camel, they may be more likely to try these products.”
   

  Source: Education News Colorado, 23 Oct 2011
  Link: http://bit.ly/pevU2d

• Qatar to move ahead with bid to curb smoking

  Qatar is considering increasing tax on cigarettes and other tobacco products in a bid to curbsmoking.

  The move also includes raising penalties on smoking in places where it is legally banned in a bid to discourage smokers from continuing with the habit and reduce the number of tobacco addicts in the country in line with the target set within goals of the National Development Plan 2011-2016.

  Smoking has been banned since in 2002 in public places, including schools and restaurants.

  Under the proposal, shopping complexes that allow smoking will be fined.

  At least one billion cigarettes are smoked in Qatar each year and on an average, an individual smokes 12,000 cigarettes annually, according to a study conducted by the Weil Cornell Medical College in Qatar.

  The study suggests that a staggering $65m is spent on cigarettes annually, while $150m is spent to cover healthcare costs of patients affected by smoking-related diseases.

  A 2006 survey shows that 25 percent of young males in Qatar are smokers, with women smokers comprising five percent.

  A study of preparatory and secondary schools conducted in 2004 suggests that nearly 26 per cent of male students and 15 per cent of female students were smokers.

  Keeping the increasing prevalence of smoking and use of other tobacco products like ‘sheesha' in view, Qatar, in its National Development Strategy 2011-2016 has set the target to reduce the rate of smoking among adult men by three per cent, from the current 32 per cent.

  
  Critics, however, remain unconvinced of the state's resolve to curb smoking and say the authorities claim they are trying to discourage smoking, but they are actually encouraging ‘sheesha' joints.

  The owners of restaurants that offer ‘sheesha' are reluctant to do away with it and say it is a major attraction for customers
   

  Source: Gulf News.com 24 Oct 2011
  Link: http://bit.ly/oeGSAI

• Blood test could identify smokers at higher risk for heart disease

  A simple blood test could some day quantify a smoker's lung toxicity and danger of heart disease, researchers at UT Southwestern Medical Center have found.

  Nearly one in five adults in the U.S. smoke, and smoking-related medical expenses and loss of productivity exceeds $167 billion annually, according to the Centers for Disease Control and Prevention. Levels of a lung protein found in the blood of smokers could indicate their risk of dangerous plaque build up in blood vessels, said Dr. Anand Rohatgi, assistant professor of internal medicine at UT Southwestern and co-lead author of the study available in Arteriosclerosis, Thrombosis, and Vascular Biology, a publication of the American Heart Association.

  "We now are close to having a blood test to help measure the smoking-related effects that contribute to atherosclerotic heart disease," Dr. Rohatgi said. "Smoking is one of the biggest contributors to the development of heart disease."

  Smokers are at an increased risk of heart attack, stroke and dying from heart disease, but the risk varies among individuals. Until this study, there had been no simple blood test to measure the varied effects of smoking on heart disease.

  Researchers determined the amount of circulating pulmonary surfactant B (SP-B), a protein found in damaged lung cells, in more than 3,200 Dallas Heart Study participants ages 30 to 65. The Dallas Heart Study was a groundbreaking investigation of cardiovascular disease that first involved more than 6,100 Dallas County residents who provided blood samples and underwent blood vessel scans with magnetic resonance imaging and computerized tomography.
   

  Source: First Science News, 25 Oct. 2011
  Link: http://bit.ly/vS9aBE