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ASH News and Events Bulletin - 1-15 February 2008

Tobacco News

FCTC: Illicit trade protocol

Significant progress towards an internationally agreed protocol to reduce tobacco smuggling was achieved at a meeting of nations in Geneva last week. Discussions were based on a template drawn up by an expert working group as a strong wish list, supported by the Framework Convention Alliance (FCA), a network of NGOs. All of the main elements of the template including licensing of manufacturers and other participants in the tobacco business, Know Your Customer procedures, tracking and tracing, duties upon manufacturers not to facilitate illicit trade in their products, record keeping, anti-money laundering measures, bans on internet and mail order sales, and a range of law enforcement and international cooperation measures remain on the table.

The next step is for the Chair of the Intergovernmental Negotiating Body to draft a Chair’s text based on the week’s discussions. That text will then be negotiated by the Parties at the next meeting of the Parties, which is likely to be held at the end of October this year. The text is expected to be released in around July.

A summary of the Chair’s informal record of the week’s negotiations meeting can be found at: http://www.who.int/gb/fctc/PDF/it1/FCTC_COP_INB_IT1_7-en.pdf
For further information about the FCA and to read the week’s bulletins see:
http://fctc.org/index.php?item=inb1-docs

Parliamentary News

PQ – Smuggled tobacco

Mr. Eric Illsley (Barnsley, Central) (Lab): [To ask the Secretary of State for Health] What recent discussions he has had with other Government Departments on the public health effects of smuggled tobacco.

The Minister of State, Department of Health (Dawn Primarolo): Tackling the problem of tobacco smuggling is a major priority for the Government. The illicit trade in cheap tobacco is helping to sustain high levels of smoking, particularly in deprived communities and among young people. My officials are working in co-operation with a range of organisations and stakeholders locally and nationally to tackle the problem.

Oral questions (Health) 5 Feb 2008

Industry Watch

RJ Reynolds to adopt fire-safer standards for all its cigarettes

In a letter to the National Fire Protection Association, RJ Reynolds announced its plan to convert to fire-safe[r] standards compliant paper on all of its cigarette brands by the end of 2009. The implementation will be phased with full distribution expected to be achieved in the latter part of 209.

Tobacco Journal International, 6/2007

Possible acquisition by Altria (Philip Morris US)

In a Q&A column in the trade journal, Tobacco Journal International, tobacco industry analyst, Bonnie Herzog speculates on a possible take-over of Swedish Match by Philip Morris USA.

Ms Herzog states: “We believe there is a more than fifty per cent chance that Philip Morris USA (or to be more precise Altria Group) will buy Swedish Match in the next eighteen months.” Herzog believes that is would make more commercial sense for PM USA to buy the Swedish company than Philip Morris International (PMI).

Firstly, Ms Herzog notes that in the US, Swedish Match would fit with PM USA’s “adjacency strategy” by complementing its interests in the cigar sector (since the American company has just purchased cigar maker John Middleton.)

Secondly, Swedish Match has a strong position in the smokeless market. As Herzog notes: “Swedish Match is an excellent fit for PM USA strategically as it could add value both within and outside the US. As the national cigarette market is declining the company is seeking to grow in adjacent markets. [However] PM USA has no brands or distribution outside the US and few staff with international experience. Buying Swedish Match would give it a number one position in the snus category globally.”

The analyst’s answer. Tobacco Journal International, 6/2007

Recent Research

Acute coronary events decreased after public smoking ban in Italy

The number of acute coronary events such as heart attack in adults dropped significantly after a smoking ban in public places in Italy, a study has found.

Researchers in Rome compared acute coronary events in the city for five years preceding a public smoking ban with those occurring one year after the ban. They found an 11.2 percent reduction of acute coronary events in persons 35 to 64 years and a 7.9 percent reduction in those ages 65 to 74.

Researchers compared the rate of acute coronary events from 2000 to 2004 to those occurring in 2005 after the ban was enforced. They identified acute coronary events from hospital discharge reports with a diagnosis of myocardial infarction or unstable angina and from the regional register of causes of deaths with diagnosis of out-of-hospital coronary deaths. The analysis was divided into three age groups: 35–64, 65–74 and 75–84 years. The researchers collected daily data on particulate matter in 40 public places and from four fixed monitors in residential areas together with temperature readings.

The indoor concentration of fine particles decreased significantly from a mean level of 119 ìg/m3 before the ban to 43 ìg/m3 one year after the ban.

During the period of the study there were changes in smoking habits such as:
frequency of smoking decreased from 34.9 percent to 30.5 percent in men and from 20.6 percent to 20.4 percent in women. Cigarette sales decreased 5.5 percent.

While the ban resulted in a significant reduction in acute coronary events in the two younger age groups, the older group (aged 75-84 years) showed no reduction.

When the researchers adjusted for time trends and all-cause hospitalization, the results remained statistically significant in the youngest group and in the 65–74 age group. This effect was only slightly reduced when the researchers compared the post-smoking ban data of 2005 to that from 2004.

“The older age group spends more time at home than in the workplace or public businesses,” said Giulia Cesaroni, M.Sc., senior researcher at the Department of Epidemiology, Rome, Italy. “The smoking ban has a greater effect on those of working age and those who spend a lot of their time in public places.”

Young people living in low socioeconomic areas seemed to have the greatest reduction in acute coronary events after the smoking ban, researchers reported. Those living in lower socioeconomic areas have worse health conditions with more risk factors for heart attack such as obesity, hypertension, diabetes and a higher rate of active smoking.

“This implies that a disadvantaged person has a higher probability of being surrounded by smokers at work and in public places unless a smoking ban is in place,” Cesaroni said.

Eurekalert 11 February 2008
http://www.eurekalert.org/pub_releases/2008-02/aha-ace021108.php

Smoking in films and tobacco use in young adults in Scotland

A study examined the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002-04) from a longitudinal cohort originally surveyed at age 11 (1994-95) were conducted. The main outcome measure is smoking at age 19.

No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers.

There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland.

Hunt K et al. An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study
Health Educ Res. 2008 Jan 17 [Epub ahead of print]

http://her.oxfordjournals.org/cgi/content/abstract/cym082v1

Smoking and genetic risk of breast cancer

Women who smoke and have a specific genetic makeup are at significant risk for the development of breast cancer, according to a recent study published by the journal Cancer Epidemiology, Biomarkers and Prevention.

A research group analyzed data from 10 of the 13 studies published in the last 10 years in which they evaluated genetic information, smoking habits and breast cancer risk in 4,889 pre-menopausal and 7,033 post-menopausal women.

Analysis demonstrated a significant interaction between breast cancer risk, smoking, and a specific gene called the NAT2 that produces the enzyme, N-acetyltransferase 2 (NAT2). This enzyme helps break down aromatic amines − a major class of tobacco smoke carcinogens – that are then excreted from the body. Individuals have either rapid or slow activity based upon their genotypes; people with the slower enzyme are unable to rid the body of aromatic amines as efficiently as those who have the faster enzyme.

As a result, the likelihood of DNA damage is greater as is the subsequent development of breast cancer. The results of this study demonstrated that women who smoked the most years, consumed the highest number of cigarettes per day and had NAT2 slow genotypes were at significantly increased risk of breast cancer. The group also performed a meta-analysis of all published studies and found similar associations.

“These results, analyzing all studies to date, indicate that subgroups of women defined by genetic predisposition are at higher risk of breast cancer if they are exposed to tobacco smoke,” said Dr. Ambrosone, lead study author. “In fact, smoking is likely to play an important role in the development of breast cancer for about 50-60% of the populations from European descent who have a form of the NAT2 gene that gets rid of aromatic amines more slowly than the rest of the population.”

Science Daily, February 11, 2008

Ambrosone, C et al. Cigarette Smoking, N-Acetyltransferase 2 Genotypes, and Breast Cancer Risk: Pooled Analysis and Meta-analysis. Cancer Epidemiology Biomarkers & Prevention 17, 15-26, January 1, 2008. Published Online First January 9, 2008

http://cebp.aacrjournals.org/

Events and Publications

Publications

Publications – WHO Report: Global Tobacco Epidemic 2008

WHO: New report outlines global tobacco control efforts

The World Health Organisation has published a new report which provides, for the first time, comprehensive information on the status of effective tobacco control measures in almost every country. It also identifies gaps in information, data and policies that must be filled. The report's key findings related to the global status of tobacco control can be summarized as follows:

More than half of countries do not have minimum monitoring information on smoking prevalence;
Only 5% of the world’s population is fully covered by comprehensive smoke-free laws;
Few tobacco users get the help they need to quit;
Few countries have comprehensive pack warnings;
Few countries enforce bans on tobacco advertising, promotion and sponsorship;
Countries can save lives by raising tobacco taxes; and
Global tobacco control funding is inadequate.

The report also reveals that governments around the world collect 500 times more money in tobacco taxes each year than they spend on anti-tobacco efforts. It finds that tobacco taxes, the single most effective strategy, could be significantly increased in nearly all countries, providing a source of sustainable funding to implement and enforce the recommended approach. The WHO has identified a package of six policies, called MPOWER.

The six MPOWER strategies are:
Monitor tobacco use and prevention policies;
Protect people from tobacco smoke;
Offer help to quit tobacco use;
Warn about the dangers of tobacco;
Enforce bans on tobacco advertising, promotion and sponsorship;
Raise taxes on tobacco.

Source: WHO News Release, 7 February 2008
http://www.who.int/mediacentre/news/releases/2008/pr04/en/index.html
additional communication from WHO, 14/2/08

WHO Report on the Global Tobacco Epidemic 2008 – the MPOWER Package:
http://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf

Events

20 February 2008 - D-MYST International Smokefree Movies Event
Venue: Liverpool
For more information contact: Samantha Towers on 0844 800 8533
Email: Samantha@mcevents.tv

27 February – Expected publication of NICE guidance on smoking cessation

27 Feb. to 1 Mar. 2008 -14th Society for Research on Nicotine and Tobacco Annual Meeting
Venue: Portland, United States
Contact: SRNT Secretariat: info@srnt.org

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