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ASH News and Events Bulletin - 16-30 April 2008

Tobacco News

More than 40% of smokers 1tried to quit in 2007

Forty three per cent of England's smokers tried to quit in 2007, and many of them several times - according to Cancer Research UK's director of tobacco studies, Professor Robert West. His findings were presented at the ASH Wales conference in Cardiff (28-29 April).

More than 27,000 smokers and ex-smokers were asked about their attempts to stop smoking in a series of monthly surveys between November 2006 and January 2008.

800,000 people (eight per cent) reported that they attempted to quit as a direct result of the smokefree legislation, which was introduced in England on 1 July 2007.

But the single biggest motivator for a quit attempt was New Year's Eve, when more than one million smokers (one in ten) made a quit attempt. Quits made at this time seemed to have more sticking power as well.

Professor West, co-director of Cancer Research UK's Health Behaviour Research Centre at UCL (University College London), said: "We know that the majority of smokers want to give up so it's very encouraging to see that half of the smokers we surveyed made a quit attempt in the past year.

"It can take many attempts to stop smoking for good, but the more times you try, the more likely you are to succeed in the end."

Half of those people who tried to quit used methods shown to improve the chances of success such as nicotine replacement therapy (NRT). The most popular NRT products were purchased over the counter and came in the form of gum, patches or lozenges.

Professor West added: "I think the best chance of success comes from getting advice and assistance from the specialist NHS Stop Smoking Service. It provides friendly advice and assistance and is based on sound evidence of effectiveness."

More than half of the smokers surveyed cut down on their smoking during the period and a quarter of these people used NRT. Research suggests that smokers are four times more likely to quit successfully with NHS support and stop smoking medicines such as patches or gum to manage cravings.

The average smoker spends about £3 per day on cigarettes. Over the course of the year, giving up would save a cigarette smoker over £1,000.

Cancer Research UK press release, 28 April 2008

Increase in quit attempts at stop smoking services in England

The latest data from the stop-smoking services reveals that for the 9-month period from April to December 2007 there was a 22% increase in the number of people stopping smoking compared to the same period in 2006, and a 12% increase on the number quitting in the same period in 2005.

At the 4 week follow-up 234,060 people had successfully quit (based on self-report); 51% of those setting a quit date.

Of those setting a quit date, success at the four-week follow up increased with age, from 37% of those aged under 18, to 59% of those aged 60 and over.

Of the 13,046 pregnant women who set a quit date, 6,556 successfully quit at the 4 week follow-up (50%).

The majority of those setting a quit date received Nicotine Replacement Therapy (NRT) only (72%). A further 13% received Champix (varenicline) only, 4% received bupropion (Zyban) only and less than 1% received both NRT and bupropion. Six per cent of people setting a quit date did not receive any smoking cessation aid and the type of treatment was unknown for a further 5%.

Champix (varenicline) was the most successful smoking cessation aid in helping people quit. Of those who used champix 63% successfully quit, compared with 54% who received bupropion only, and 48% who received NRT.

Statistics on NHS Stop Smoking Services in England, April to December 2007. The Information Centre for Health and Social Care. Release date: 16 April 2008

http://www.ic.nhs.uk/pubs/sss07q3

Public demand more Government action to curb smoking

The government is to launch a public consultation next month on its plans to tighten legislation on the sale of tobacco - but new research reveals that people, including smokers, are already demanding more action.

A poll carried out for ASH revealed that:

• 76% of GB adults support a ban on smoking in cars carrying children under the age of 18,
• 85% of adults in England and Wales want retailers who are convicted of selling tobacco illegally to children to be banned from selling tobacco products, and
• 88% of adults in Scotland agree that businesses found to have sold or supplied tobacco to under-18s more than once should have their right to sell tobacco suspended.

Results of the research were due to be presented at the ‘Call to Action’ tobacco control conference organised by ASH Wales (28-29 April).

The government is considering action to restrict or ban the display of tobacco products in shops as well as a possible ban on cigarette vending machines.

The ASH research shows a majority of people are in favour of these policies but for the following measures more than three out of four want more action:

• Easier access to quitting medications, such as nicotine gum and patches (82%);
• Licences for tobacco vendors, which should be removed if they are caught selling to underage smokers; (87%)
• A crackdown on tobacco smuggling (75%).

Report author Martin Dockrell said:

“The law on smokefree public places has been very popular. Our research shows that almost two out of three (63%) people strongly support it compared to only one in 12 who are strongly opposed. People understand that it is not about smokers: 76% say smokefree legislation has been good for their health and overall people support a wide range of further tobacco control measures.”

ASH press release 28 April 2008

Key findings of the survey are available at: http://www.ash.org.uk/files/documents/ASH_684.pdf

Parliamentary News

PQ – Effect of tobacco display ban at point of sale

Andrew Lansley asked the Secretary of State for Health what assessment his Department has made of the likely effect of banning the display of cigarettes in shops on smoking levels among (a) adults and (b) children.

Dawn Primarolo (Minister of State – Public Helth) replied: In the “Cancer Reform Strategy” published in December 2007, the Department undertook to consult on the next steps in tobacco control later this year. We will consider evidence on the issue during the consultation. However, a preliminary assessment of the published evidence from jurisdictions including Cancada, Australia and New Zealand suggests that in-store advertising of tobacco, including point-of-sale displays, has an impact on children and young people’s attitudes to smoking.

HoC Hansard col 1184W 21 April 2008
http://tinyurl.com/6yxn99

Industry Watch

OFT accuses tobacco companies and retailers of colluding on cigarette prices

Tobacco manufacturers and retailers engaged in "unlawful practices" as they swapped information about the future prices of cigarettes, the Office of Fair Trading has claimed.

The OFT claims that Imperial Tobacco and Gallaher - alongside 11 retailers including Tesco and Sainsbury - engaged in one or more unlawful practices in relation to retail prices. The allegations follow a five-year investigation by the OFT.

The regulator believes that manufacturers and retailers "were indirectly exchanging information about future prices". The OFT will outline full details of the alleged infringements in its "statement of objections" which will be sent to the companies in the coming days.

Both Sainsbury and Tesco are understood to be assisting the regulator with its investigation, in return for substantially reduced fines or even complete immunity.

"If proven the alleged practices would amount to a serious breach of the law," said John Fingleton, chief executive of the Office of Fair Trading. "For markets to work well for consumers, it is a fundamental principle that pricing decisions should be made independently."

The alleged infringements span periods between 2000 and 2003.

In a statement, Imperial Tobacco said it "takes compliance with competition law very seriously and rejects any suggestion that it has acted in any way contrary to the interests of consumers". Gallaher said it was assisting the OFT.

A Tesco spokesman said: "The OFT's investigation appears to centre on major tobacco companies. We do not believe that Tesco has acted in a way that has harmed consumers and we will make this clear to the OFT when we see the details of their allegations."

A Sainsbury spokesman said: "Sainsbury's has co-operated fully with the OFT since 2003 and, as a result, can expect total immunity from any potential resulting fines in the event the OFT concludes there has been an infringement."

The groups named in the inquiry have around two months to respond.

Companies involved in anti-competitive pricing practices can face fines of up to 10 per cent of the relevant annual turnover.

The Daily Telegraph, 24 April 2008
http://tinyurl.com/6fx2qv

PM test markets mini cigarette in response to smoking bans

Philip Morris has launched a new ‘mini cigarette’, Marlboro Intense, which can be smoked faster but has the same amount of nicotine as the full-size version. The new cigarette is 7.2cm long – considerably shorter than the 8.5cm standard Marlboro - and is designed to appeal to individuals who can only take quick, outdoor cigarette breaks while at work. The mini cigarette delivers the same amount of nicotine as the full size version.

The new cigarette is being test-marketed initially in Turkey but Philip Morris envisages a world-wide demand, now that more than 50 countries have smoking bans in public places. Health groups in Turkey have accused Philip Morris of deliberately testing their product in an under-developed country and of taking advantage of the high smoking prevalence in Turkey.

Tobacco Journal International, Feb/March 2008
www.tobaccojournal.com

Recent Research

Smokers’ beliefs about ‘light’ cigarettes 2 years’ after the ban

A study was undertaken to examine how beliefs of smokers in the United Kingdom (UK) were affected by the removal of light and mild brand descriptors, which came into effect on September 30, 2003 for Member States of the European Union (EU).

The data are derived from the first 4 waves (2002-2005) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, United States, United Kingdom, and Australia (15,450 individual cases).

The UK ban on misleading descriptors occurred around the 2nd wave of data collection in the ITC survey, allowing a comparison of beliefs about light cigarettes among adult smokers in the UK both before and after the ban, with beliefs in the three other ITC countries unaffected by the ban.

There was a substantial decline in reported beliefs about the benefits of Lights in the UK following the policy change and an associated public information campaign, but by 2006 (i.e., Wave 4), these beliefs rebounded slightly and the change in beliefs was no greater than in the United States, where there was no policy change.

The findings reveal that high levels of misperceptions about light cigarettes existed among smokers in all four countries before and after the EU ban took effect.

The authors conclude that packaging is not a major factor in reducing misconceptions about “light” cigarettes, at least up to two years after implementation. It remains possible that the effects will be greater in the longer term as smokers forget (and new smokers never learn) that less harsh-tasting cigarettes used to be called “Lights”. It seems likely that at least part of the misconception about “lights” is the result of sensory perceptions resulting from the easy draw and cooler feel associated with heavily ventilated cigarettes which in turn reinforces the perception in the smokers’ mind their cigarettes, these so-called low tar cigarettes, are less harmful relative to other so-called higher tar less ventilated cigarettes. Some of the misperception is also likely to be due to the use of yield figures on packs, which bear no clear relationship to human exposures. It is important to gain a more complete understanding of the methods the tobacco industry uses to convey to consumers the sense that some brands are somehow less dangerous than others, especially those that are independent of any real differences in harmfulness, and to counteract those methods through the formulation of effective policies and informational strategies.

Borland, R et al. What Happened to Smokers’ Beliefs about Light Cigarettes When "Light/Mild" Brand Descriptors Were Banned in the UK? Findings from the International Tobacco Control (ITC) Four Country Survey
Tob Control. Published Online First: 21 April 2008.

doi:10.1136/tc.2007.023812
http://tobaccocontrol.bmj.com/cgi/content/abstract/tc.2007.023812v1

Proactively offering cessation support to smokers in primary care settings

Abstract

Aims To establish whether proactively identifying all smokers in primary care populations and offering smoking cessation support is effective in increasing long-term abstinence from smoking.

Design Cluster randomized controlled trial.

Setting Twenty-four general practices in Nottinghamshire, randomized by practice to active or control intervention.

Participants All adult patients registered with the practices who returned a questionnaire confirming that they were current smokers (n = 6856).

Intervention Participants were offered smoking cessation support by letter and those interested in receiving it were contacted and referred into National Health Service (NHS) stop smoking services if required.

Measurements Validated abstinence from smoking, use of smoking cessation services and number of quit attempts in continuing smokers at 6 months.

Findings Smokers in the intervention group were more likely than controls to report that they had used local cessation services during the study period [16.6% and 8.9%, respectively, adjusted odds ratio (OR) 2.09, 95% confidence interval (CI) 1.57–2.78], and continuing smokers (in the intervention group) were more likely to have made a quit attempt in the last 6 months (37.4% and 33.3%, respectively, adjusted OR 1.23, 95% CI 1.01–1.51). Validated point prevalence abstinence from smoking at 6 months was higher in the intervention than the control groups (3.5% and 2.5%, respectively) but the difference was not statistically significant (adjusted OR controlling for covariates: 1.64, 95% CI 0.92–2.89).

Conclusions Proactively identifying smokers who want to quit in primary care populations, and referring them to a cessation service, increased contacts with cessation services and the number of quit attempts. We were unable to detect a significant effect on long-term cessation rates, but the study was not powered to detect the kind of difference that might be expected.

Murray R et al. The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial
Adddiction 2008 Early online edition
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1360-0443.2008.02206.x

Events and Publications

Events

BUPA Foundation Awards 2008 - Call for entries.
The annual BUPA Foundation Awards are made to healthcare and medical professionals in recognition of excellence in healthcare. Current award categories, which each will receive a prize of £15,000, are:
• Care Award – for excellence in the development of care for older people;
• Research Award – for the best emerging medical researcher in the UK;
• Epidemiology Award – for excellence in the epidemiological study of human disease;
• Clinical Excellence Award – for work that demonstrates an improved clinical outcome for patients;
• Health at Work Award - for excellence in occupational medicine;
• Communication Award – for effective communication between health care professionals and patients;
• Patient Safety Award – for outstanding contribution to patient safety.
Applications are open to healthcare professionals who are resident and working in the UK. Closing date for entry is 1 July 2008
For full details visit: www.bupafoundation.co.uk
For an application form please call: 020 7656 2246 or E-mail: iona.chessells@btinternet.com

7-8 June – 5th World Conference on Non-Smokers’ Rights
Venue: Washington DC
For more information see: http://nosmokingcontest.org/5thconf
or email info@nosmokingcontest.org

16-18 June – 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

30 June – 1 July– 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.

23-26 September – 10TH European SRNT Conference
Venue: Rome
and it will close on 15th June 2008.
The preliminary programme will be made available at the official
website: www.srnt2008rome.com
Further information from: info@anteprimadue.it

1-4 October – 11th European Health Forum Gastein: Theme - Values in Health: from vision to reality
Venue: Bad Hofgastein, Salzburg, Austria
Details: www.ehfg.org

2 October – BASSP 2nd Conference
Venue: Manchester University
The British Association for Stop Smoking Practitioners (BASSP)
is a membership organisation committed to helping stop smoking practitioners communicate and share their knowledge and experience.
The focus for this one day event will be smoking and mental health and how to collect and analyse data from your [stop smoking] service.
Please contact Louise Preston for more details about contributing to the conference (lapreston@ntlworld.com).
Full details about the conference (including online booking) and also BASSP membership are available at: www.brit-thoracic.org.uk/bassp

4-8 October – European Respiratory Society Annual Congress
Details: info@ersnet.org

27-29 October - SCTRP three-day course, Central London
Contact Janice Rossabi, SCTRP Course Secretary at sctrp@yahoo.co.uk

2- 7 November - ICAA Conference on Dependencies
International Council on Alcohol and Addictions.
Venue: Cyprus The theme of the conference is "Empowerment for Practitioners" which will particularly focus on capacity building and target all those who work in prevention, treatment, research and policy development.
Details: www.icaa2008.org

5 December - SCTRP 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

8-12 March 2009 - 14th World Conference on Tobacco or Health
Venue: Mumbai, India. Early registration discount until 15 Sept. 2008
Last date for abstract submission: 23 May 2008
Details: www.wctoh.org