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ASH News and Events Bulletin - 16-30 April 2011

HEADLINES

EVENTS

  • Treasury to cut duty free tobacco as part of £2 billion tax clawback

    The number of cigarettes holidaymakers may bring back from Europe without attracting questions from Customs officials is to be cut by more than two-thirds as part of a Treasury attempt to claw back some of the £2.2bn in tax lost to tobacco smuggling every year.

    The proposed change sets a guideline limit of 800 cigarettes and 1kg of rolling tobacco. Current limits of up to 3,200 cigarettes and 3kg of rolling tobacco were set in 2002 after an attempt to clamp down further met with opposition.
     
    Treasury minister Justine Greening is to set out plans to slash existing guideline limits, bringing them in line with Ireland and many other parts of Europe.  Greening said she believes this will "start to deter those people who are actually just using minimum indicative levels as a way of bringing in wholesale amounts of cigarettes."

    The Tobacco Manufacturers Association said it would not oppose the reduced guideline limits .

    More than one in 10 cigarettes smoked in the UK is smuggled or bought legitimately by overseas travellers. The figure for rolling tobacco is almost half. Tobacco sales nevertheless generate £8.8bn in tax each year for Treasury coffers.

    Deborah Arnott, chief executive of Action on Smoking and Health said: "ASH welcomes much of HMRC's new strategy particularly increased investment in tackling smuggling. However, there is too much weight placed on collaboration with the tobacco industry which has historically been a major driver of smuggling, and no reference to the UK's obligations to protect tobacco control from the vested interests of the tobacco industry. And there is no clear ambition for the size of reduction in the illicit market which they expect to achieve from this increased investment."
    Source: The Guardian, 27 April 2011
    Link: http://bit.ly/dK9E9S

  • USA: FDA will regulate e-cigarettes as tobacco products

    The Food and Drug Association (FDA) will regulate electronic cigarettes the same way it regulates other tobacco products, the agency has announced.

    The government has decided not to appeal a federal appeals court decision holding that e-cigarettes
    can be regulated as "tobacco products" under federal law.
     
    Under the federal Tobacco Control Act, tobacco products are subject to restrictions even though they are not considered drugs or devices. The law subjects new tobacco products and modified risk tobacco products  to premarket review.
     
    The FDA now intends to propose a regulation that would extend the agency's regulation of tobacco products to include "other categories of tobacco products, a group that is expected to include e-cigarettes. The additional tobacco product categories would be subject to general controls, such as registration, product listing, ingredient listing, good manufacturing practice requirements, user fees for certain products, and the adulteration and misbranding provisions.
    Source: MedPage Today, 26 April 2011
    Link: http://bit.ly/eDvVQp

  • Australia: Cancer Council predicts more apartment smoking bans

    The Cancer Council of South Australia says a ban on smoking inside Australian apartments is "entirely possible and even probable".

    Earlier this month an eight unit apartment block in western Sydney introduced a by-law making the premises completely smokefree.

    Professor Brenda Wilson, the chief executive of Cancer Council SA, predicts it will not be the last.

    She added: "The fact remains that secondhand smoke is harmful. The level of exposure can determine a person's risk and you could imagine many would like to have the choice that their home be a safe haven - something that poses quite a challenge in a shared setting such as apartment blocks."

    Source: ABC News, 18 April 2011
    Link: http://bit.ly/gLurTO

  • USA: Smoking bans spreading, but some states still love smokers

    By 2020, every state in the nation may ban indoor smoking in public places, the Centers for Disease Control has predicted.

    Dr. Tim McAfee, director of the CDC's Office on Smoking and Health, said: "It is by no means a foregone conclusion that we'll get there by 2020.  But the success of the smoking ban movement has been astounding, and seems to be accelerating.  I'm relatively bullish we'll at least get close to that number."

    In 2000, no states had comprehensive indoor smoking bans. By 2010, 26 states did.

    Source: CBS News - 22 April 2011
    Link: http://bit.ly/g7duxR

  • China Bans Smoking in Restaurants, Hotels, Rail Stations, Airports

    A ban on smoking in most public places in China goes into effect Sunday, a move that health experts say will help raise awareness of the dangers of smoking in a country where tobacco use is deeply ingrained.

    There is a lack of public awareness of the health risks of smoking in China. The World Health Organization says seven out of ten non-smoking adults in the East Asian nation are exposed to second-hand smoke each week. Smokers light up in elevators and offices, and even in hospital waiting rooms.

    From 2 May, the country’s estimated 300 million smokers will no longer be allowed to puff their cigarettes in what the Chinese government is calling "enclosed public places." These include hotels, restaurants, theaters and public transport waiting rooms. The ban does not cover offices or factories.

    Hong Kong University School of Public Health Director Tai Hing Lam says the ban will be effective in informing the public about the dangers of smoking.

    "With this new legislation, this will promote awareness, and that is a major step," said Lam.

    He says non-smoking Chinese, who make up the majority of the population, should understand that second-hand smoke is harmful to their health. He hopes the new ban will help encourage them to ask for more smoke free places.

    "Non smokers at the moment are too passive, let us put it that way, because they’re so used to being exposed," he said. "So, they do not realize that they have the right to demand it [smoke free places]. Now, the law actually empowers them."

    The new regulation does not specify what the penalties should be for people who violate the ban.

    Therefore, enforcement is expected to be difficult, which is a point that both supporters and opponents of the smoking ban agree on.

    The new ban comes more than four months after a deadline imposed by the World Health Organization Framework Convention on Tobacco Control. China signed the agreement five years ago.

    WHO data show more than 3,000 people die every day in China due to smoking, which contributes to four of the country’s five leading causes of death

    Source: Los Angeles Times, 1 May 2011
    Link: http://bit.ly/mRP4tp

  • PQ - Tobacco Point of Sale display ban

    Tobacco: Retail Trade

    Mr Sanders: To ask the Secretary of State for Health if he will assess the capacity of supermarkets to comply with proposals for a tobacco display ban.

    Anne Milton: The Impact Assessment included in the Explanatory Memorandum to the Tobacco Advertising and Promotion (Display) (England) Regulations 2010, sets out the Department's assessment of the likely impact on retailers of implementing the legislation to end displays of tobacco products in shops in England.

    Mr Sanders: To ask the Secretary of State for Health pursuant to the answer of 21 March 2011, Official Report,column 775W, on tobacco: sales, with which representatives of retailers his Department is working to develop guidance.

    Anne Milton: The legislation ending tobacco displays in shops in England will come into effect in the first instance for large shops on 6 April 2012 and for other shops on 6 April 2015. Departmental officials are currently developing guidance for large shops. The Department will continue to engage with the British Retail Consortium and the Association of Convenience Stores as representatives of large retailers, as well as the supermarket chains Tesco, Sainsbury's, Asda, Morrisons, Waitrose and the Co-operative

     

    Source: Hansard, House of Commons Written Answer , 27 April 2011
    Link: http://bit.ly/mfEtqf

  • BAT admits bankrolling newsagents' tobacco campaign

    British American Tobacco has admitted funding an organisation of small shopkeepers that led the fight against the coalition government's plans to prohibit the display of cigarettes in shops. Speaking at BAT's annual meeting in London, company chairman Richard Burrows confirmed that the tobacco group had funded the National Federation of Retail Newsagents (NFRN) and attended meetings with the group and its lobbyists Hume Brophy to discuss the campaign against the point-of-sale move. 

    The admission followed an earlier denial that the company had funded the NFRN campaign. The day before, BAT told the Guardian that claims that it was involved in "underhand tactics and the funding of an independent retailer organisation, via a PR agency" were "untrue".

    Their relationship raises questions about Hume Brophy's tactics when it was lobbying MPs against the plan, as it said it was representing the NFRN and did not disclose BAT's role.

    Activists, among them the Labour MP Kevin Barron and Action on Smoking and Health, have voiced fears over "covert lobbying" of MPs by big tobacco companies.

    Andrew Lansley, the Health Secretary, had refused to deal with cigarette manufacturers over the issue as a World Health Organisation treaty forbids it. He will now be asked whether he was aware of BAT's role in making representations to MPs.

    Source: The Guardian, 28 April 2011
    Link: http://bit.ly/kydlYF

  • Imperial Tobacco tipped for BAT take over

    Industry analysts are predicting a possible takeover of Imperial Tobacco by BAT.  Shares in Imperial rose 1.9 per cent to £20.39 after Goldman Sachs argued that the cigarette maker was the most likely takeover target when sector consolidation returns.

    Low debt levels, strong cash generation, below average valuations and a lack of organic growth among the main cigarette makers suggest conditions are right for the four biggest tobacco makers to become three, said analyst Fulvio Cazzol.

    Of the four, Philip Morris International would face too many competition hurdles while Japan Tobacco looked an unlikely bid target given the Japanese government’s blocking stake, Goldman said. The most likely deal was therefore that British American Tobacco would buy Imperial, the smallest of the four, it continued.

    Such a combination would require BAT to sell Imperial’s assets in markets including Germany and Australia, as well as exiting Reynolds American, BAT’s US joint venture.

    Access to the full article requires registration.

    Source: FT - April 2011
    Link: http://on.ft.com/gt47vQ

  • Tobacco firms used diet-aid chemicals

    British and American tobacco companies deliberately added powerful appetite-suppressing chemicals to cigarettes to attract people worried about their weight, according to internal industry documents dating from 1949 to 1999. Chemical additives are just one of several strategies successfully used by tobacco companies over the past 50 years to convince people that smoking makes you thin.

    Tobacco giants Philip Morris and British American Tobacco added appetite suppressants to cigarettes, according to the documents, released during litigation in the US. Four other major companies tested potential chemicals, including amphetamine and nitrous oxide, better known as laughing gas, but the documents, which are incomplete, do not reveal if such chemicals were ever added and sold to the public.

    The presence of appetite-suppressing chemicals could help explain why smokers who quit often gain weight, according to Swiss researchers in the European Journal of Public Health.

    Professor David Hammond, a tobacco industry expert at Waterloo University, Ontario, Canada, said: "We know the industry explored ways to exploit concerns about weight loss back in the Sixties, because they knew it was an issue that concerned women, who they wanted to recruit as smokers. We don't know if appetite-suppressing molecules are still added, because compliance with additive regulations is poor and sensitive internal documents are usually shredded."

    A Canadian study of 500 young women, published in Tobacco Control this month, found those looking at female-oriented cigarette packs branded with words such as "slim" and "vogue", were more likely to believe smoking helps people control their appetite – an important predictor of smoking among this group – compared with those viewing plain packaging. Smokers wrongly believe that certain words, such as the names of colours, and long, slim cigarettes mean the brand is less harmful, according to a study, that included 2,000 Britons, published in Addiction.

    Action on Smoking and Health (ASH) is urging the Health Select Committee to force tobacco companies to disclose documents that would shed light on marketing strategies, including product packaging and design, to help MPs make an informed choice about introducing plain packaging.

    Deborah Arnott, Chief Executive of ASH, said: "Now advertising is banned, the industry uses pack design and product descriptors, such as "slims", to promote the message that smoking makes you thin. It must be required to put its products in plain, standardised packaging to prevent it using such "dog whistle" tactics to promote smoking to vulnerable young women."

    Source: The Independent - 24 April 2011
    Link: http://ind.pn/ftWSPx

  • Australia: Tobacco funded ad campaign

    Public health experts say a campaign that links plain cigarette packaging with children buying unbranded  loose tobacco from criminal gangs is grossly misleading and indicative of a desperate industry.

    The Association of Australian Retailers, which is funded by the tobacco industry, has been running advertisements claiming children as young as 14 are smoking illegal tobacco, smuggled by ''highly organised criminal networks''.

     Kypros Kypri, an associate professor in the school of medicine and public health at the University of Newcastle, said there was no indication in the survey of how the 0.1 per cent of 14- to 19-year-olds who reported smoking unbranded loose tobacco had obtained it. ''I don't know of any study that shows 14-year-olds get illegal tobacco from criminal gangs,''  he said.

    Leaked internal documents prepared by the public relations strategists The Civic Group reveal the ads were designed to be ''aggressive'' and to ''identify and leverage existing emotional drivers and prejudices''.

    Mike Daube, a professor of health policy at Curtin University, said other alliance ads had similarly dubious claims, and that the Australian Institute of Health and Welfare survey of more than 23,000 people had found fewer than one in 10 people had actually smoked unbranded tobacco.
    Source: Sydney Morning Herald, 27 April 2011
    Link: http://bit.ly/eCeHI3

  • Use of Varenicline for 4 Weeks before quitting smoking

    Background The use of varenicline tartrate alleviates postquit withdrawal discomfort, but it also seems to reduce the "reward" associated with smoking. The current treatment schedule, which commences 1 week before quitting, relies primarily on the first mechanism. We set out to determine whether increasing the prequit medication period renders cigarettes less satisfying and facilitates quitting.

    Methods One hundred one smokers attending a stop-smoking clinic in London, United Kingdom, were randomly allocated to receive varenicline for 4 weeks before the target quit date (TQD) or to receive placebo for 3 weeks before the TQD, followed by varenicline for 1 week before the TQD. In both groups, standard varenicline treatment was given for 3 months after the TQD. Measures included smoking satisfaction and smoke intake before quitting, urges to smoke and withdrawal discomfort after quitting, and sustained abstinence from the TQD to 3 months.

    Results Varenicline preloading reduced prequit enjoyment of smoking (P = .004) and smoke intake (P < .001), with 36.7% of participants reducing their cotinine concentrations by more than 50% (reducers). Varenicline preloading did not affect postquit withdrawal symptoms, but it increased 12-week abstinence rates (47.2% in the varenicline arm vs 20.8% in the placebo arm, P = .005). The effect was particularly strong among the reducers in the varenicline arm (66.7% in reducers vs 22.6% in nonreducers, P = .002). Varenicline preloading was well tolerated.

    Conclusions Although several issues remain to be clarified, varenicline preloading can generate a substantial reduction in ad lib smoking and enhance 12-week quit rates. Current treatment schedules may lead to suboptimal treatment results. Trials with longer follow-up periods are needed to corroborate these findings.
     

    Hajek, P et al. Use of Varenicline for 4 Weeks before quitting smoking.  Arch Intern Med. 2011;171(8):770-777.

    Source: Arch Intern Med. 2011;171(8):770-777.
    Link: http://bit.ly/kJRKKx

  • Increasing the age for the legal purchase of tobacco in England


    Background The minimum age for the legal purchase of tobacco increased from 16 to 18 years in England, Scotland and Wales on 1 October 2007. The authors examined the impact of this legislation on disparities in smoking behaviour and access to cigarettes among youth in England.

    Methods A multivariate logistic regression analysis was carried out adjusting for secular trends in regular smoking using data from the Smoking, Drinking and Drug Use Survey, a national survey of 11–15 year olds. The primary outcome measure was regular smoking and the predictor variables were the law increasing the minimum age for purchase and eligibility for free school meals (FSM).

    Results Increasing the minimum age for purchase was associated with a significant reduction in regular smoking among youth (adjusted OR 0.67; 95% CI 0.55 to 0.81, p=0.0005). This effect was not significantly different in pupils eligible for FSM compared with those that were not (adjusted OR 1.29; 95% CI 0.95 to 1.76, p=0.10 for interaction term). The percentage of pupils who stated that they found it difficult to buy cigarettes from a shop did not increase in those eligible for FSM (25.2% to 33.3%; p=0.21) but did increase significantly in others (21.2% to 36.9%; p<0.01) between 2006 and 2008. No differences in ease of purchase were found between pupils eligible for FSM and those not before or after the legislation (2006: p=0.34, 2008: p=0.55).

    Conclusions Increasing the age for the legal purchase of tobacco was associated with reduced regular smoking among youth in England and appeared to have a similar impact in different socio-economic groups.

    Millet, C. et al. Increasing the age for the legal purchase of tobacco in England: impacts on socio-economic disparities in youth smoking.  Thorax doi:10.1136/thx.2010.154963
     

    Source: Thorax, Published Online 17 April 2011
    Link: http://bit.ly/eIWQI3

  • Measurement of tobacco smoke at entrances to office buildings

    Introduction An unintended consequence of indoor smoking restrictions is the relocation of smoking to building entrances, where non-smokers may be exposed to secondhand smoke, and smoke from outdoor areas may drift through entrances, exposing people inside. Tobacco smoke has been linked to numerous health effects in non-smokers and there is no safe level of secondhand smoke (SHS) exposure. This paper presents data on levels of tobacco smoke inside and outside entrances to office buildings.

    Methods Real-time air quality monitors were used to simultaneously measure respirable particulate matter (PM2.5; air pollutant particles with a diameter of 2.5 μm or less) as a marker for tobacco smoke, outside and inside 28 entrances to office buildings in downtown Toronto, Ontario, in May and June 2008. Measurements were taken when smoking was and was not present within 9 m of entrances. Background levels of PM2.5 were also measured for each session. A mixed model analysis was used to estimate levels of PM2.5, taking into account repeated measurement errors.

    Results Peak levels (10 s averages) of PM2.5 were as high as 496 μg/m3 when smoking was present. Mixed model analysis shows that the average outdoor PM2.5 with smoking was significantly higher than the background level (p<0.0001), and significantly and positively associated with the number of lit cigarettes (p<0.0001). The average level of PM2.5 with ≥5 lit cigarettes was 2.5 times greater than the average background level.

    Conclusions These findings support smoke-free policies at entrances to buildings to protect non-smokers from exposure to tobacco smoke.

    Kaufan, P et al.  Not just ‘a few wisps’: real-time measurement of tobacco smoke at entrances to office buildings.  Tob Control 2011;20:212-218 doi:10.1136/tc.2010.041277

    Source: Tobacco Control, April 2011
    Link: http://bit.ly/knTmld

  • High levels of carbon monoxide found in patrons of hookah cafes

    A new University of Florida study shows that patrons leaving hookah cafés had carbon monoxide levels more than three times higher than patrons exiting traditional bars.

    Carbon monoxide reduces the blood’s ability to carry oxygen to tissues, and long-term exposure has been linked to cardiovascular disease. The UF study results appeared in the March issue of the American Journal of Preventive Medicine.

    The social nature of hookah smoking, which is often shared in groups, makes it appealing to young people, said lead researcher Tracey Barnett, an assistant professor in the UF College of Public Health and Health Professions’ department of behavioral science and community health.

    “There is also a common misperception that hookah smoking is a harmless alternative to cigarette smoking,” she said.

    Hookah pipes are composed of a head, where lit charcoal and tobacco sit, a body with water bowl, and a hose. Air is drawn through the tobacco and into the pipe body where it passes through the water before being inhaled through the hose.

    A study led by Barnett showed that 11 percent of Florida high school students and 4 percent of middle school students surveyed in 2007 had tried hookah smoking. It is especially popular among college students. A University of Memphis study estimated that 10 percent to 20 percent of some young adult populations are current hookah users.

    The new UF study is the first to measure carbon monoxide levels of hookah smokers “in the field.”

    “Our study is unique because we were actually getting participants as they were leaving these establishments,” Barnett said. “There’s been a lot of great lab work on hookah and carbon monoxide levels, but doing a behavior in the lab is not the same as when young adults are out with their friends in an environment where there’s also drinking and socializing, so with this study we were catching them in a real-world moment as best we could.”

    Study data were collected in April, September, October and November 2009 outside Gainesville establishments. Using a breath carbon monoxide tester, researchers measured the carbon monoxide levels of 173 hookah café patrons and 198 patrons of traditional bars that allow smoking. Under Florida’s Clean Indoor Air Act, smoking is permitted in establishments that generate less than 10 percent of revenue from food sales.

    The average carbon monoxide level of hookah patrons was 30.8 parts per million while traditional bar-goers had an average carbon monoxide reading of 8.9 ppm. Even hookah café patrons who reported not engaging in hookah smoking while in the café demonstrated elevated carbon monoxide levels: on average 11.5 ppm, an amount comparable to a carbon monoxide level of a regular cigarette smoker.

    The Occupational Safety and Health Administration’s maximum level for carbon monoxide exposure is 50 ppm over an eight-hour period.

    The average carbon monoxide levels of the hookah café patrons in the UF study were similar to previous lab studies of hookah smokers, but the upper ranges of carbon monoxide levels reached by study participants exceeded those in lab studies, Barnett said.

    In the UF study, 18 percent of hookah café patrons had carbon monoxide levels above 50 ppm compared with 1.5 percent of traditional bar patrons. Eight hookah café patrons involved in the study, or 5 percent, tested above 90 ppm. People may experience symptoms of carbon monoxide poisoning, such as headache, fatigue and nausea, at 70 ppm and sustained exposure at 150 ppm to 200 ppm leads to disorientation and unconsciousness, according to the U.S. Consumer Product Safety Commission.

    The high levels of carbon monoxide associated with hookah smoking can be attributed to the tobacco, the piece of burning charcoal used to warm the tobacco, and the nature of hookah use, in which users may smoke continuously for an hour or more, Barnett said.

     

    Source: University of Florida news, 7 April 2011
    Link: http://bit.ly/dVSL3n

Events

  • World No Tobacco Day

     World No Tobacco Day 2011 is designed to highlight the WHO Framework Convention on Tobacco Control (WHO FCTC)'s overall importance, to stress Parties' obligations under the treaty and to promote the essential role of the Conference of the Parties and WHO in supporting countries' efforts to meet those obligations. The Conference of the Parties is the treaty's central organ and governing body.

    Date: 31 May 2011
    Contact: http://www.who.int/tobacco/wntd/2011/announcement/en/index.html

  • UK National Smoking Cessation Conference

    Presentations, workshops and debates cover all aspects of the policy and practice of helping smokers to stop. This two-day conference is the leading forum for discussion of evidence based service delivery and community innovations.

    All patient groups are covered, including pregnant smokers, young people, those with mental health problems, in secure environments, and hard to reach groups. Treatment modalities are also comprehensively addressed with presentations describing the state of the art on new medications, forthcoming treatments (like the nicotine vaccine), as well as researchers and practitioners presenting the latest on optimising existing treatments that are known to be effective, such as Nicotine Replacement Therapy (NRT), with results of work looking at combining products and 'pre-loading' prior to quitting.

    Although smoking cessation is the main focus of the conference, tobacco control measures such as smoke free public places and harm reduction are also discussed, particularly in relation to how they impact on services helping people to stop smoking.

    www.uknscc.org

    Date: 13 June 2011
    Venue: Novotel London West, Hammersmith, London
    Contact: 01305 262244, or email updates@uknscc.org

  • Health and Wellbeing – the 21st Century Agenda

    The second international conference organised by the journal Public Health is taking as its theme health and wellbeing. The conference will explore the relationships between health, wellbeing and the factors which influence them in a global environment. 


    website

    Date: 08 September 2011
    Venue: Friends House, 173-177 Euston Road, London, NW1 2BJ
    Contact: crobins@rsph.org.uk

  • UN Summit on Non-Communicable Diseases

    The Summit will focus on the four most prominent non-communicable diseases, namely, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. The aim of the summit is to agree on a global strategy to address NCDs.

    There will be a High-level meeting of the UN General Assembly on the prevention and control of Non-communicable Diseases (19-20 September 2011), while Non-communicable disease indicators are on the agenda for discussion during the Millennium Development Goals Review Session (20-22 September 2011).

    Date: 19 September 2011
    Venue: New York City, USA
    Contact: http://bit.ly/dOgoW4

  • 14th European Health Forum Gastein

    The EHFG has developed into a key annual event, bringing together, politicians, senior decision-makers, representatives of interest groups, and experts coming from government and administration, business and industry, civil society and science and academia.

    Date: 05 October 2011
    Venue: Salzburg, Austria
    Contact: http://www.ehfg.org/registration.html?&L=0

  • Fiftieth anniversary of RCP report on smoking and health

    To mark the 50th anniversary of the publication of its first report on Smoking and Health in 1962, the Royal College of Physicians is organising a one-day conference.

    Date: 06 March 2012
    Venue: Royal College of Physicians
    Contact: http://events.rcplondon.ac.uk/details.aspx?e=2497

  • 15th World Conference on Tobacco or Health

    The premier, international conference on tobacco control attracts thousands of academics, practitioners, non-government organisations and public officials. 

    Date: 20 March 2012
    Venue: Singapore
    Contact: http://wctoh2012.org