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ASH News and Events Bulletin - 16-31 March 2008

Tobacco News

Wales: Support for smoking ban – 1 year on

On the first anniversary of the smoking ban in Wales, figures show that just 79 people have been issued with fines for breaking the law. The Welsh Assembly reports that there have been consistently high rates of compliance in Wales and growing support for the public health legislation, which outlawed smoking in all enclosed public and workplaces.

The latest survey suggests that 84% of adults in Wales support smoke-free public places, compared with 71% before the ban, according to the Welsh Assembly Government.

The Assembly Government is now expected to focus its attention on, and try to promote, smoke-free homes, in a bid to reduce children’s exposure to second-hand smoke.

Dr Tony Jewell, Wales’ chief medical officer, said, “The introduction of the smoking ban in enclosed public places has been a milestone for public health and the single most important measure that the Welsh Assembly Government could take to improve the health of the nation and reduce health inequalities.”

Wales was the first country in the UK to vote in favour of a smoking ban, but because it lacked law-making powers, the legislation was not introduced until April last year – after Scotland and Ireland.

But in the year since the ban, air quality in pubs has improved by up to 77%, in line with the Scottish experience.

About a third of Wales’ adult smokers – a quarter of the population smokes – said that they were smoking fewer cigarettes.

The Assembly Government expects the health benefits of the ban to be similar to those in Scotland.

Early research findings from Scotland, where smoke-free legislation came into force in March 2006, have been extremely positive. These include a 17% reduction in heart attack admissions and an 86% reduction in bar workers’ exposure to second-hand smoke.

Western Mail, 31/3/08
http://icwales.icnetwork.co.uk/news/wales-news/2008/03/31/support-for-smoking-ban-grows-one-year-on-91466-20694631/

Retailers’ concerns over cost of implementing cig display ban

Government proposals to ban the open display of cigarettes in shops would lead to "considerable operational and equipment costs" according to the Association of Convenience Stores (ACS).

"We would expect the government to present a clear case that these measures were necessary before placing yet another significant burden on thousands of retailers across the country," said ACS chief executive James Lowman.

The proposal will be one of several suggested in the government's forthcoming policy consultation on tobacco regulation as part of its Cancer Reform Strategy. It would mean that tobacco products would be forced out of sight - probably under the counter. Lowman continued: "If the Department of Health brings forward new tobacco regulations, we will work constructively, but critically, to ensure that these meet their own principles of better regulation, in particular that the burdens that any measures imposed on business are proportionate and effectively targeted."

He also argued that the government had more pressing matters to address: "One-fifth of all tobacco smoked in the UK is supplied by the black market and the government has to do more to tackle those who sell illegal and counterfeit tobacco."

The Department of Health's consultation process is due to start in late May. Other options expected to be discussed include the ban of 10s packs of cigarettes, the ban of tobacco vending machines and the introduction of a retailer licensing scheme.

Forecourt Trader, 31 March 2008
http://www.forecourttrader.co.uk/news/fullstory.php/aid/2194/High_cost_of_ban_on_tobacco_display.html

Parliamentary News

PQ: Tobacco – Restricted premises and sales orders

David Taylor asked the Secretary of State for Health when and by what means he plans to monitor the effectiveness of restricted premises and sales orders when they are implemented; what information will be collected as part of the monitoring arrangements; and over what period the information will be collected.

Dawn Primarolo (Minister of State (Public Health): The first report on the impact of restricted premises and sales orders will be published in 2010, a year after the powers for magistrates to make the orders are due to come into force. Thereafter, a report will be made to Parliament annually.

Hansard source 20/03/08 – Column 1328W
http://tinyurl.com/3y4nr5

_{Ed Note: The orders relate to a system of ‘negative licensing’ which means that retailers who persistently break the law by selling tobacco to minors face the possibility of having their right to sell tobacco removed.}

PQ: Smoking and Pregnancy

Andrew Lansley asked the Secretary of State for Health what percentage of women have continued to smoke through pregnancy in each year since 1997 for which figures are available, broken down by (a) region and (b) primary care trust.

Dawn Primarolo (Minister of State (Public Health): The information requested is not available in the format requested. Information on the percentage of mothers nationally who smoked during pregnancy in 1995, 2000 and 2005 is available from the editions of the Infant Feeding Survey as follows.

'Infant feeding 1995: A survey of infant feeding practices in the United Kingdom', Table 3.8 on page 37 which was published on 1 January 1997.

Hansard source, 26/03/08 – Column 214W
http://tinyurl.com/3bfofr

_{Ed Note: The 2005 Infant Feeding Survey revealed that 32% of mothers reported smoking in the 12 months before or during pregnancy. Of these, 17% continued to smoke throughout pregnancy.}

Industry Watch

Altria splits Philip Morris into 2 companies

The Altria Group Inc. holding company has split its two cigarette units into Philip Morris USA and Philip Morris International. Altria now consists of Philip Morris USA, cigar maker John Middleton Inc., a money-management arm, and a 28.6 percent stake in the UK-based beer maker SABMiller plc.

Both Philip Morris companies will continue to produce Marlboro cigarettes. PMUSA also makes Virginia Slims, Parliament and Basic cigarettes while PMI makes the L&M, Bond Street and other brands.

The breakup frees Philip Morris International from legal and public relations concerns in the U.S. In preparation, PMI has created a range of new Marlboro-branded products for fast-growing markets around the world. Some of the cigarettes are designed to cater to local tastes: the clove-based Marlboro Mix 9 in Indonesia; thicker Marlboro Wides in Western Europe, Japan and Mexico; and Marlboro Fresh Mint and Crisp Mint in Hong Kong.

The larger PMI, which operates in more than 160 countries, earned revenue of $55.1 billion in 2007, compared to PMUSA's $18.49 billion.

Louis Camilleri, who was chief executive of Altria, is the new CEO of the international business. PMI has an office in New York but most of its staff works out of a Lausanne, Switzerland, office.

While PMI escapes the shadow of pending and yet-to-be-filed lawsuits in the U.S., critics of the industry are wary of the damage its marketing power could have on consumers in poorer nations.

The U.N.'s World Health Organization issued a report in February that said the "tobacco epidemic" could claim 1 billion lives by the end of the century unless governments dramatically step up efforts to curb smoking. The agency reported that governments around the world collect more than $200 billion in tobacco taxes every year but spend less than one-fifth of 1 percent of that revenue on tobacco control.

Business Week, 28 March 2008
http://www.businessweek.com/ap/financialnews/D8VMMG300.htm

Turkey: Competition Board approves TEKEL sale to British American Tobacco

The Competition Board has approved the sale of alcohol and tobacco monopoly TEKEL’s tobacco division to British American Tobacco (BAT).

The Competition Board decided that the takeover of TEKEL’s tobacco division by BAT would not cause any competition problems in the market.

BAT won the tender for TEKEL’s tobacco division on Jan. 22 of this year with a $1.72 billion bid. TEKEL tobacco has six factories in addition to 56 leaf tobacco and two salt operations and employs roughly 15,000 people. TEKEL’s operating profits reached YTL 199 million in 2006, and the company accounts for approximately 38 percent of the domestic tobacco market.

Today’s Zaman, 29 March 2008
http://www.todayszaman.com/tz-web/detaylar.do?load=detay&link=137597

Recent Research

A computerized smoking cessation intervention for High School smokers

Abstract

This study evaluated a computerized intervention designed to assist high school-aged smokers to consider not smoking and move forward in the “Stages of Change.” A pretest-posttest pilot was conducted with 121 high school students who completed self-reported questionnaires that provided information about smoking history and exposure, smoking dependence, stage of change, and social support. Following baseline assessment, the experimental group (n = 61) completed four, 30-minute computerized sessions known as the Computerized Adolescent Smoking Cessation Program (CASCP). Immediately following completion of the program and 1 month later, the experimental subjects were reassessed. Control subjects completed baseline assessment and were reassessed 4 to 5 weeks later.

CASCP increased the number of quit attempts. At 1 month after the intervention, 20% of the experimental group quit smoking. Of those subjects who did not quit smoking, nicotine dependence and the number of cigarettes smoked daily decreased, which decreased their nicotine dependence. Overall, there was a forward movement in the experimental group’s stage of change.

CASCP was found to be an effective and inexpensive intervention that motivates adolescent smokers to consider smoking cessation, move forward in the stage of change, and decrease nicotine dependence.

Fritz, D et al. A computerized smoking cessation intervention for High School smokers. Pediatric Nursing 2008; 34: (1) Jan/Feb 2008

www.pediatricnursing.net/issues/08janfeb/abstr1.html
www.pediatricnursing.net/ce/2010/Article34013027.pdf

Related J Sch Nurs research:

Program strategies for adolescent smoking cessation
www.ncbi.nlm.nih.gov/pubmed/18220452

Smoking won't help teens lose weight and may stunt growth

Smoking cigarettes won't help teenage girls lose weight but it may stunt teen boys' growth, a Canadian study suggests.

The study found that teenage boys who smoke are on average 2.54 centimetres shorter than non-smokers.

"Girls who smoked did not end up skinnier than girls who did not smoke. They ended up having a similar height and BMI," said lead author Dr. Jennifer O'Loughlin, of the Department of Social and Preventive Medicine at the University of Montreal. "However the evidence presented supports the old adage 'Don’t smoke. It will stunt your growth', at least in boys."

The study said the effect on boys' heights may be because they are still growing when they start to smoke.

The researchers surveyed 1,293 Montreal teens from age 12 to 17 every three months about their smoking and lifestyle habits.

O'Loughlin said the researchers were most surprised to find that there was no link between weight and smoking habits but said the findings can be integrated into prevention messages to help persuade teens not to start smoking.

"Girls might not start smoking if they realize that they will not end up skinnier than girls who don’t smoke," she said. "Boys may not start smoking if they think they might end up shorter and smaller overall if they smoke."

She said the findings "might also help uncover the reasons why smoking affects birth weight and possibly growth in adolescents."

The study is part of the Natural History of Nicotine Dependence in Teens Study, funded by the Canadian Cancer Society.

CBC News, 26 March 2008

Study link: Does Cigarette Use Influence Adiposity or Height in Adolescence?
O’Loughlin J et al Annals of Epidemiology
http://www.sciencedirect.com/science/journal/10472797

Smoking and back pain in adolescents

A prospective cohort study in adolescents was undertaken to evaluate whether smoking in adolescence is a risk factor of low back pain (LBP) among young adults.

Children belonging to the northern Finland Birth Cohort 1986 were examined at birth and at 16 years of age and followed up by a postal questionnaire at the age of approximately 18 years. The primary outcome was LBP during the past 6-month period. Incident cases reported LBP at 18 but not at 16 years. Persistent cases reported pain at both time points.

Regular smoking at 16 years was associated with persistent LBP in girls (OR: 2.52; 95% CI: 1.40-4.53). Daily smoking of over 9 cigarettes at 16 was associated with persistent LBP (2.57; 1.03-6.46) and predicted incident pain in girls (2.80; 1.11-7.09). Pack-years of smoking were associated with incident and persistent LBP in the girls with an exposure-response relationship, whereas these associations were inconsistent in the boys. Pack-years of smoking at 18 years showed an exposure-response relationship with persistent Consultation for LBP, which was strongest in those with over 1.5 pack-years of exposure (5.82; 1.39-24.42).

The authors concluded that regular smoking in adolescence was associated with LBP in young adults. Pack-years of smoking showed an exposure-response relationship among girls.

Mikkonen P et al. Is smoking a risk factor for low back pain in adolescents? A prospective cohort study. Spine. 2008 Mar 1;33(5):527-32.
http://tinyurl.com/33gusf

Events and Publications

Events

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 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 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
Contact Janice Rossabi, SCTRP Course Secretary at sctrp@yahoo.co.uk

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