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ASH News and Events Bulletin - 16-31 July 2010

HEADLINES

EVENTS

  • A Survey of NHS Stop Smoking Services

    Abstract:
    Background: People with mental health problems exhibit smoking rates up to three times that of the general population. Metabolic interactions between hydrocarbon agents in tobacco smoke and some antipsychotic drugs account for a change in medication metabolism on stopping smoking, and potentially for increased blood levels. Untreated nicotine withdrawal can mimic or exacerbate symptoms of mental illness, such as depression. Therefore, appropriate screening for mental health problems and liaison with local mental health care providers should be a priority for NHS Stop Smoking Services. The present study aimed to examine this issue through surveys with NHS Stop Smoking Service staff in London.

    Method: Semi-structured telephone interviews were conducted with one senior staff member from 27 of the 29 NHS Stop Smoking Services in London. RESULTS: It was found that only a minority of services routinely check the mental health status or mental health service use of their clients. In addition, most services do not routinely implement special checks or actions when mental health problems are revealed. In addition, respondents reported a lack of strategic drivers supporting work with mental health patients and a low level of partnership working with local mental health care providers.

    Conclusions: NHS Stop Smoking Services may not be operating appropriate procedures for supporting people with mental health problems. There is a need for local protocols to be implemented that include routine screening for mental health issues and liaison with mental health care providers.
     

    McNally and Ratschen. The Delivery of Stop Smoking Support to People with Mental Health Conditions: A Survey of NHS Stop Smoking Services. BMC Health Services Research 2010, 10:179

    Source: BMC Health Services Research - 24 June 2010
    Link: http://bit.ly/c4XwlY

  • Active and passive smoking and pain

    Abstract

    Background: It is controversial whether the association between back pain, and other types of chronic pain, and smoking is causal or not. AIM: To examine the relationship between frequent pain and smoking, and between frequent pain and exposure to environmental tobacco smoke (ETS) in smokers and non-smokers.

    Methods: A randomised population-based study, Inter99 (1999-2006), Denmark. Subjects in the intervention groups (N=6784; participation rate=52.5%) completed self-report questionnaires. Cross-sectional data from baseline were analysed in adjusted logistic regression analyses to investigate the relationship between active and passive smoking and frequent pain in the back, abdomen, joints and head.

    Results: Daily smokers reported significantly more frequent pain in every of the six locations, and in several, minimum three, locations (OR=1.98 (95%CI=1.6-2.4)) than never smokers. We found a dose-response relationship between frequent pain and intensity of both active and passive smoking (test-for-trend p<0.001). Those exposed to 5h or more of ETS reported significantly more frequent pain than those almost never exposed to ETS (non-smokers: OR=1.46 (95%CI=1.2-1.8), and smokers: OR=2.04(95%CI=1.4-3.0)). Also, an earlier smoking debut and an increasing number of pack-years increased the probability of frequent pain in daily smokers (test-for-trend p<0.05).

    Conclusion: We found significant association, dose-response and reversibility between active smoking and frequent pain in all six locations. Furthermore, we found that increasing intensity of ETS increased the probability of frequent pain in non-smokers, which has not been shown before. In conclusion, several findings in this study indicate a causal link between tobacco smoke and pain, which is supported by recent prospective studies.

    Pisinger, C. et al, The association between active and passive smoking and frequent pain in a general population. European Journal of Pain. in advance of print

    Source: European Journal of Pain - 04 June 2010
    Link: http://bit.ly/ck5CsI

  • Altria group: appeals court restricts use of Engle findings

    An appeals court has restricted the ability of about 4,000 plaintiffs in the so-called Engle progeny cases in federal court to use findings by a prior jury to back up their cases at trial.

    The individual Engle suits against Altria and other tobacco companies, including Reynolds American Inc. (RAI), came up after a court ruling some years ago that decertified the Engle class action case but allowed individual cases within a stipulated time.

    The court's decision applies to the approximately 4,000 Engle claims pending in federal court against the tobacco companies. Separately, there are several thousand Engle cases against the tobacco companies in state courts in Florida.

    The original class action had been named after pediatrician Howard Engle, who was a lead plaintiff on the original suit, brought on behalf of thousands of smokers allegedly suffering smoking-related diseases. Many of the individual cases have been filed by relatives of smokers who died of diseases linked to smoking.

    Source: ADVFN India - 22 July 2010
    Link: http://bit.ly/a6i7AU

  • Anti-smoking review is cancelled

    Smoking will not now be banned in parks and cars, after a health minister said the coalition had decided to cancel a planned review of the legislation.

    Anne Milton, the public health minister, said there was no need for the review as existing legislation "is working".

    In March 20 senior doctors called for a sweeping extension to anti-smoking laws, urging the government to prohibit smoking in vehicles and public places visited by children like parks and playgrounds.

    The Royal College of Physicians' Tobacco Advisory Group argued that while banning smoking in enclosed public places had been highly effective, there were "still gaps that needed to be closed".

    Its report warned that 9,500 children had to be admitted to hospital every year due to passive smoking.

    Forest, the smokers' lobby group, described the proposal as "unacceptable and unenforceable".

    Speaking at a conference at the King's Fund think-tank in London on how the coalition government planned to improve public health, Mrs Milton said: "We have studied the smokefree legislation and decided not to proceed with the planned review, because we feel the legislation is working."

    Further plans on smoking will be revealed in a forthcoming public health white paper.

    Source: The Telegraph, 28 July 2010
    Link: http://bit.ly/b0p6X8

  • BAT boss Paul Adams stubs out cigarettes ahead of exit

    The boss of Britain's biggest tobacco firm has given up smoking cigarettes, it has emerged.

    Paul Adams, chief executive of British American Tobacco, kicked the habit after spending 19 years selling millions of packets of Dunhill, Kent and Lucky Strike to smokers.

    Seven of those years were spent at the helm of the London-based business.

    The smoking habits of tobacco groups' executives have always attracted close scrutiny.

    In 2002, BAT took a battering when its then chairman Martin Broughton admitted smoking is bad for you and he wouldn't advise his children to smoke.

    However, a spokesman for the company was last night at pains to point out that Adams still smokes cigars, saying: 'Paul Adams smokes Dunhill cigars. He no longer smokes cigarettes.'

    She later insisted that he is still a smoker: 'Whether someone smokes pipes, cigars, cigarettes, or rollies they are still a smoker.

    'He is still a consumer of tobacco. It would not be correct to say that Paul has "kicked the habit".

    'If he'd given up smoking then that would be fine, but he hasn't so it's not true.' Adams' decision to quit the fags emerged as the 56-year-old, who is standing down as chief executive next year, also revealed his plans for life after BAT.

    While most FTSE bosses migrate to non-executive roles and chairmanships, Adams will be taking a gap year to visit foreign cities with his family.

    'I think I deserve some time off,' he told the Mail. 'You've heard of "backpacking" - we will be going "flash packing" - staying in nice hotels.'

    He was speaking as BAT said first- half pretax profits increased from £2.1bn a year ago to £2.3bn. Revenues rose 8pc to £7.3bn in the period.

    The firm hiked the dividend by almost a fifth from 27.9p to 33.2p, but the shares shed 17p to 2,242.5p after volumes fell 3pc.

    Adams, pictured above, said the trend was now improving but people had been smoking less for three reasons.
    'When a recession bites people will either smoke less, stop smoking or in some markets switch to smuggled or counterfeit tobacco.'

    Source: Daily Mail - 28 July 2010
    Link: http://bit.ly/9e6FIf

  • Black market tobacco trade could be stubbed out

    It’s a familiar refrain from the tobacco industry: high excise hikes on tobacco products lead more consumers to buy their cigarettes on the black market. Governments should therefore be careful not to raise duty too sharply.

    The clamour for higher tobacco duty from global governments in the last year should therefore have been a boon to spivs hawking cheap cigarettes the world over. Except of course on a global scale, this simply isn’t the case. In a year when governments across the world have been raising their excise rates on tobacco in an effort to trim their budget deficits, we should be seeing a huge rise in the illicit tobacco market. Right?

    Well no. British American Tobacco’s Chief Executive Paul Adams said Wednesday there had been only a “slight rise” in the illicit market in the last year despite all the “significant” and “swingeing” excise increases mentioned in the company’s first-half results.

    Some individual markets were undoubtedly affected. In Romania for instance, the percentage of cigarettes bought on the black market rose to 36% once government tax rises led to a doubling in the price of a pack. That percentage has now come down to around 24%, according to Adams. This reduction was not brought about by any reduction in the excise duty, however, but by a tightening of border controls.

    Similar government action has led to a sharp reduction in the Canadian black market–where once again there were no price reductions.

    So perhaps the link between high excise duty and the illicit tobacco trade is not quite as strong as we’re led to believe. Besides which, tobacco firms appear less concerned about fueling the illicit market when it comes to raising their own prices. The fact that BAT managed to raise is first half sales by 4%, despite flat volumes, suggests it had no qualms about raising the price of its Dunhills, Lucky Strikes or Pall Malls.

    That’s not to suggest that illicit trade isn’t an issue of course. It accounts for about 12% of the world’s cigarette volumes. That means 12% of tobacco sales are effectively unregulated, with none of the strict controls on underage smoking the rest of the market faces. As the Canadian example and the recent experience in Romania have shown however, it is perhaps stricter border controls, and more stringent law enforcement rather than more modest duty increases that is best used to combat the problem.

    Source: Wall Street Journal - 28 July 2010
    Link: http://bit.ly/aOUMpc

  • Evaluating the effects of e-cigarettes

    Abstract

    Background: Electronic “cigarettes” are marketed to tobacco users as potential reduced exposure products (PREP), albeit with little information regarding electronic cigarette user toxicant exposure and effects. This information may be obtained by adapting clinical laboratory methods used to evaluate other PREPs for smokers.

    Methods: Thirty-two smokers participated in four independent Latin-square ordered conditions that differed by product: own brand cigarette, “NPRO” electronic cigarettes (NPRO EC; 18 mg cartridge), “Hydro” electronic cigarettes (Hydro EC; 16 mg cartridge), or sham (unlit cigarette). Participants took 10 puffs at two separate times during each session. Plasma nicotine and carbon monoxide (CO) concentration, heart rate, and subjective effects were assessed.

    Results: Own brand significantly increased plasma nicotine and CO concentration and heart rate within the first five minutes of administration whereas NPRO EC, Hydro EC, and sham smoking did not. Own brand, NPRO EC, and Hydro EC (but not sham) significantly decreased tobacco abstinence symptom ratings and increased product acceptability ratings. The magnitude of symptom suppression and increased acceptability was greater for own brand than for NPRO EC and Hydro EC.

    Conclusions: Under these acute testing conditions, neither of the electronic cigarettes exposed users to measurable levels of nicotine or CO, although both suppressed nicotine/tobacco abstinence symptom ratings.

    Impact: This study illustrates how clinical laboratory methods can be used to understand the acute effects of these and other PREPs for tobacco users. The results and methods reported here will likely be relevant to the evaluation and empirically based regulation of electronic cigarettes and similar products.

    Vansickel, A. A Clinical Laboratory Model for Evaluating the Acute Effects of Electronic “Cigarettes”: Nicotine Delivery Profile and Cardiovascular and Subjective Effects. Cancer Epidemiology, Biomarkers & Prevention, in advance of print

    Source: American Association for Cancer Research - 20 July 2010
    Link: http://bit.ly/cl2oXT

  • Gareth Davis boards William Hill as Chairman

    Gareth Davis, recently retired CEO of Imperial Tobacco, has joined William Hill plc as their new Chairman.

    He joined Imperial Tobacco in 1972 as a management trainee and undertook various roles in the business, including Managing Director of International Operations from 1988. He was appointed Chief Executive in 1996 and led the successful demerger of Imperial Tobacco from Hanson plc and subsequent listings on the London and New York Stock Exchanges.

    He played a key role in the development and execution of Imperial Tobacco's strategy and its development into a leading multi-national business. Since 2003, Mr Davis has also been a non-executive director of Wolseley plc, where he is also senior independent director. 

    Source: Investegate - 28 July 2010
    Link: http://bit.ly/bPlS8B

  • Illicit trade health & revenue

    Aims The purpose of this study was to update global estimates of the illicit cigarette trade, based on recent data, and estimate how many lives could be saved by eliminating it and how much revenue governments would gain.

    Data sources and methods Our estimates of illicit market share are based on formal and informal sources. Our method for estimating the effect of eliminating the illicit trade on tobacco related deaths is based on West et al. with some minor modifications, and involves calculating the size of the illicit cigarette trade; the effect of eliminating it on the price of cigarettes and thus on consumption; the revenue governments are losing because of it; and the number of tobacco-related premature deaths that would be avoided if this illicit trade were eliminated.

    Results According to available estimates, the size of the illicit trade varies between countries from 1% to about 40–50% of the market, 11.6% globally, 16.8% in low-income and 9.8% in high-income countries. The total lost revenue is about $40.5 billion a year. If this illicit trade were eliminated governments would gain at least $31.3 billion a year, and from 2030 onwards more than 164 000 premature deaths a year would be avoided, the vast majority in middle- and low-income countries.

    Conclusions The burden of deaths and lost revenue caused by the illicit cigarette trade falls disproportionately on low- and middle-income countries. Eliminating this trade would avoid millions of premature deaths, and recover billions of dollars for governments

    Joossens, L. et al, The impact of eliminating the global illicit cigarette trade on health and revenue. Addiction. Article online in advance of print

    Source: Interscience - 12 July 2010
    Link: http://bit.ly/avFpM3

  • Imperial Tobacco's cigarette volumes drop

    mperial Tobacco said cigarette volumes for the nine months to June were down 4.3% as a result of market declines in Spain, USA, Russia and Ukraine being only partly offset by gains in Central Europe.

    Overall, the group’s financial performance for the financial year to 30 September remains in line with expectations.

    However, its global strategic cigarette brands continued to grow and it saw some strong performances from a number of regional and local brands.

    Chief executive Alison Cooper said: "Overall we are performing well in what remains a challenging operating environment, highlighting the resilience of our business and the success of our growth strategy.”

    “By continuing to leverage our comprehensive brand and product portfolio across our balanced international footprint we are well placed to further build sales and create sustainable value for our shareholders."

    Source: Sharecast, 22 July 2010
    Link: http://bit.ly/dkukxm

  • Irish Cancer Society says claims by retailers that drop in sales due to Point of Sale regulations defy belief

    The Irish Cancer Society has responded to claims by Retailers Against Smuggling that the advertising ban on cigarettes in shops has led to a drop in cigarette sales of 40%, by saying that official figures show otherwise.

    Kathleen O'Meara, Head of Advocacy and Communications in the Irish Cancer Society, said the retailers’ claim that sales were down 40% defied belief.

    “It is unclear where these figures have come from, but what is clear from all official data is that there is absolutely no link between the introduction of the point of sale advertising ban and cigarette sales in Ireland.”

    “In fact, according to CSO figures published in recent days, spending on tobacco actually rose by over 3% last year to €2.3 billion, practically the only growth sector in the economy.”

    Month on month figures for the duty paid on cigarettes from the Department of Finance show an increase in the amount of duty paid in each of the four months immediately after introduction of point of sale legislation from August to November 2009.

    “The Annual Report of the Office of Tobacco Control reports 98% compliance by stores with the point of sale legislation. We welcome this high level of compliance and congratulate all those retailers who are ensuring that young people in particular are not exposed to the subtle marketing practices of the tobacco industry by complying with the point of sale regulations,” said Ms O’Meara.  

    Source: Irish Cancer Society - 15 July 2010
    Link: http://bit.ly/bMBGuK

  • JTI launches Winston, its flagship brand, in the UK

    TI is launching Winston, its No.1 Global Flagship brand, across the UK next month. Since its launch in London last year, JTI will be reducing the cost price and recommended retail price (RRP) of the Winston range to take advantage of the significant growth for value brands. Winston is now perfectly positioned to meet this increase in demand should retailers choose to reposition the brand within the Value cigarette sector.

    From 1st August, the Winston range of Red and Blue 20s will be available for retailers to stock nationwide, with an RRP of £4.79, and from this date Price Marked Packs will also be available to independent retailers, to help support the change.

    The Value cigarette segment currently has a 22.6% share of market in the UK, and is growing volume at 56% year on year. Combined with Winston having experienced nine consecutive years of double-digit growth worldwide[1], the brand has great potential in the UK market.

    Jeremy Blackburn, JTI's Head of Communications, says: "Winston is the second bestselling cigarette in the world, and a brand with an established heritage, strong reputation, and international appeal. The launch across the UK, new RRP and new Price Marked Packs will allow retailers to capitalise on the growing demand for quality cigarettes at a more affordable price."

    Independent retailers are advised to take advantage of this new profit opportunity by stocking the full range of new Winston Price Marked Packs.

    Source: Talking Retail, 27 July 2010
    Link: http://bit.ly/9TXb60

  • Point-of-sale advertising major cause of teen smoking, study shows

    A study to be published in the August issue of Pediatrics led by Lisa Henriksen, PhD, senior research scientist at the Stanford Prevention Research Center, reports that teens' exposure to cigarette advertising at retail outlets substantially increases the odds they will start smoking. According to the findings, students who visited these stores on a regular basis were at least twice as likely to try smoking as those who visited infrequently.

    "The tobacco industry argues the purpose of advertising is to encourage smokers to switch brands, but this shows that advertising encourages teenagers to pick up a deadly habit," said Henriksen, who has studied tobacco marketing for more than a decade.

    The study's publication comes just as the new federal Tobacco Regulation Law goes into effect, empowering the U.S. Food and Drug Administration to regulate the manufacturing, marketing and sale of tobacco products. As of June 22, tobacco companies are banned from using terms such as "light," "low" and "mild" on advertising and packaging and sponsoring cultural and sporting events, but regulators may impose additional constraints if warranted.

    Point-of-sale is the major form of marketing used for tobacco, representing 90 percent of the industry's $12.5 billion marketing budget in 2006, and the study suggests that further limits on such activity could affect long-term smoking habits. The teen years are when the vast majority of smokers start, and if teens make it through to adulthood without smoking, their likelihood of ever becoming addicted is very small, Henriksen said.

    In recent years, the decline in teenage smoking has leveled off. According to the Centers for Disease Control and Prevention, high-school students who reported current cigarette use declined sharply from a peak of 36.4 percent in 1997, to 21.9 percent in 2003, after which the percentage dropped just a little to 19.5 in 2009. "The huge decreases are really starting to slow," said Henriksen. "The train won't continue downhill without further action. Regulating retail marketing would be ideal for smoking prevention."

    Henriksen based the study on repeat surveys of 11- to 14-year-olds at three middle schools in Tracy, Calif., and assessments of cigarette advertisements at stores near the schools. The survey included questions about students' smoking experience as well as how often they visited the types of stores with lots of cigarette adverts, convenience stores, gas stations, small groceries — and then checked back later, first at one year and then at 30 months.

    Of the 2,110 students surveyed in 2003 when the study began, 1,681 reported never smoking. A survey of these non-smoking students a year later revealed 18 percent of these students had smoked over the year, at least one puff, and that smoking initiation was much more prevalent among the students who had reported frequent visits to stores with the most cigarette ads.

    Among those who had reported visiting these types of stores at least twice a week, 29 percent had taken at least one puff in the previous year. Among those who rarely visited — less than twice a month — only 9 percent had smoked at all.

    A survey 30 months after the study began found that by then 27 percent had tried smoking: 34 percent of those who visited stores at least twice a week, and only 21 percent of those who rarely visited.

    To measure exposure to ads, the researchers multiplied the frequency of visits by the number of advertising "impressions" in stores near the schools — cigarette-branded ads, product displays and functional objects, like clocks, trash cans and register mats. On average, students experienced 325 cigarette-brand impressions per week, ranging from an average of 114 among infrequent shoppers to 633 among those who shopped frequently.

    "I was surprised by the sheer number of cigarette brand impressions in signs and displays in convenience stores near schools," said Henriksen. "The exposure is unavoidable. It's impossible to miss."

    Factors other than advertising influence smoking. To determine the effect of point-of-sale advertising alone, the researchers measured many other factors so they could hold these constant in the analysis. These other factors included risk-taking behaviour, unsupervised time after school, exposure to smoking in movies or on TV, and smoking by household members and friends. The researchers also factored in grades and demographics including gender, race and ethnicity.

    When the project's statistician adjusted for all the variables, she found that the relationship between store visits and smoking initiation was strong. A year after the survey, those who had initially reported moderate visits (a frequency between once every two weeks and twice a week) were 64 percent more likely to have taken at least one puff than infrequent shoppers. Those frequent shoppers, who had reported more than two visits a week, were more than twice as likely. Even 30 months after the initial survey, by which time more students had begun smoking, the apparent influence of the store visits remained: Those who had initially reported moderate store visits were 19 percent more likely than infrequent visitors to have tried smoking; those who had reported frequent visits were 42 percent more likely to have had a puff.

    How can simply spending time in the presence of advertisements make such an impact? "Young people are very susceptible to advertising messages," said Stanford adolescent medicine specialist Seth Ammerman, MD, who treats patients at Lucile Packard Children's Hospital and researches smoking cessation. Ammerman was not involved in the study.

    "One particularly nefarious aspect of advertising at convenience stores is it really normalizes the product. What do you buy there? Cigarettes, but also soup, laundry detergent, soda, cat food — normal, common things. So advertising there really gives the impression that smoking is normal," said Ammerman, a clinical professor of adolescent medicine at Stanford. "Tobacco companies understand this. They're not stupid."

    Source: Psysorg, 18 July 2010
    Link: http://bit.ly/asEIEy

  • Relations between parents smoking and infants exposure to tobacco smoke

    Background
    The aims of the present study were to examine relations between parents' self-reported smoking behavior and infants' daily exposure to environmental tobacco smoke, as assessed by urinary cotinine-to-creatinine ratio (CCR), and to describe the CCR over seven days among infants at home.

    Methods
    A convenience sample of 27 households was drawn. Each household had to have at least one daily tobacco smoker and one child up to three years of age. Over a seven-day period, urine samples were obtained from the child daily. To examine relations between parents' self-reported smoking and infants' daily CCR, generalized estimating equation (GEE) analysis was used.

    Results
    The data revealed that infants from households with indoor smoking had higher CCRs than infants in households with outdoor smoking. CCRs were higher in girls than in boys. Older infants had lower CCRs than younger infants. Smoking outside the home versus inside the home, infant's gender, and infants' age accounted for 68% of the variance in CCR in a GEE data analysis model. No increase or decrease of CCR over time was found.

    Conclusion
    The findings suggest that parents' self-reported smoking indoors at home versus outdoors is predictive of CCR among infants three and younger. Higher CCR concentrations in girls' urine need further examination. Furthermore, significant fluctuations in daily CCR were not apparent in infants over a seven-day time period.

    Kehl, D. et al, A descriptive analysis of relations between parents' self-reported smoking behavior and infants' daily exposure to environmental tobacco smoke. BMC Public Health 2010, 10:424

    Source: BMC Public Health - 19 July 2010
    Link: http://bit.ly/a2G84Q

  • Smoking images on YouTube

    Abstract
    Introduction: Smoking imagery on the online video sharing site YouTube is prolific and easily accessed. However, no studies have examined how this content changes across time. We studied the primary message and genre of YouTube videos about smoking across two time periods.

    Methods: In May and July 2009, we used "cigarettes" and "smoking cigarettes" to retrieve the top 20 videos on YouTube by relevance and view count. Eliminating duplicates, 124 videos were coded for time period, overall message, genre, and brand mentions. Data were analyzed using descriptive statistics.

    Results: Videos portraying smoking positively far outnumbered smoking-negative videos in both samples, increasing as a percentage of total views across the time period. Fifty-eight percent of videos in the second sample were new. Among smoking-positive videos, music and magic tricks were most numerous, increasing from 66% to nearly 80% in July, with music accounting for most of the increase. Marlboro was the most frequently mentioned brand.

    Discussion: Videos portraying smoking positively predominate on YouTube, and this pattern persists across time. Tobacco control advocates could use YouTube more effectively to counterbalance prosmoking messages.
     

    Forsyth, S. et al, "I'll be your cigarette—Light me up and get on with it": Examining smoking imagery on YouTube. Nicotine & Tobacco Research 2010 12(8):810-816

    Source: Oxford Journals - 15 June 2010
    Link: http://bit.ly/aOQrDV

  • Third-hand smoking

    In a previous study of ‘secondhand’ cigarette smoke, we showed that 75% of the particles added to indoor air were of ultrafine sizes and had a half-life in air of 18 minutes at 25°C. These particles after their deposition on household surfaces could be later put back in suspension and constitute a toxic ‘thirdhand’ smoke which has not, as yet, been documented through quantitative data. Consequently, we undertook direct measurements of the concentration and sizes of smoke particles after their deposition and resuspension in a closed room.

    A smoking device burned 10 cigarettes in 30 minutes in a non-ventilated furnished room that was then kept closed. On the next day, for particle resuspension, we mobilised the dust on furniture, clothes and surfaces by wiping and shaking and created even more turbulence with a ventilator.

    An impactor (ELPI) measured the particle sizes (between 0.28 μm and 10 μm) and concentration in the air, 60 cm above the floor:

    on the first day before and after the cigarettes were smoked (secondhand smoke) then 4 hours later.

    24 hours later, before and after resuspension manoeuvres (thirdhand smoke).

    Median diameter, concentration in number and mass of particles were respectively:

    0.18 μm, 1.31.106.ml −1 and 15.4 mg.m−3 after smoking

    0.30 μm, 0.98.104.ml−1 and 0.62 mg.m−3 4 hours later

    0.07 μm, 1.66.102.ml−1 and 0.05 mg.m−3 1 day later.

    0.15 μm, 0.92.104.ml−1 and 0.50 mg.m−3 1 day later after resuspension manoeuvres.

    This showed that after cigarette smoking:

    the airborne particles were of ultrafine sizes.

    their concentration was divided by 100 in the first 4 hours and again by 100 in the following 24 hours. After resuspension, the concentration was multiplied by 100, going back to that observed 4 hours after smoking. This rise can only be attributed to particles smaller than 0,3 μm since other measurements made after resuspension manoeuvres without previous smoking only increased the concentration of particles over 0.3 μm of size.

    These quantitative data support the hypothesis of a resuspension from the cigarette smoke surface contamination. However, this airborne contamination through resuspension remains much lower (100 times) than that of secondhand smoke. The rest of the aerosol mass initially produced by cigarettes could be firmly attached either to surfaces, leading to ingestion hazards and dermal transfer or to household dust and be inhaled with it

    Becquemin, M. et al. Third-hand smoking: indoor measurements of concentration and sizes of cigarette smoke particles after resuspension. Tobacco Control. 2010;19:347-348

    Source: Tobacco Control - 07 June 2010
    Link: http://bit.ly/ahGEya

  • Tobacco and cannabis use at a music festival

    Abstract

    Background: Music festivals are known to attract a high proportion of drug users.

    Methods: Using a survey of 1,772 visitors at the Roskilde Festival in Denmark, we assessed substance use at the festival, the incidence of use of substances among never-users and the incidence of use among lifetime users who had not used a substance in the past 12 months.

    Results: New onset of tobacco use was reported by 9.2% of never-smokers, and new onset of cannabis use was reported by 9.3% of never-smokers of cannabis. Resumption of tobacco use was reported by 24% of past year abstainers, and resumption of cannabis use was reported by 30% of past year abstainers. New onset of other types of substances was reported by less than 0.5% of subjects, but among past year abstainers, 5-10% reported resumption of amphetamine, ketamine, MDMA and cocaine use. New onset smokers of cannabis were significantly younger than never-smokers.

    Conclusion: Music festivals such as the Roskilde Festival may be important arenas for the prevention of onset of tobacco and cannabis use and for a return to substance use

    Hesse, M. et al, The Use of Tobacco and Cannabis at an International Music Festival. European Addiction Research 2010;16:208-212

    Source: Karger - 02 July 2010
    Link: http://bit.ly/anaH6I

  • Tobacco display ban to be scrutinised in ministerial meeting

    Opponents of the tobacco display ban are pinning their hopes of a last-minute reprieve on a ministerial meeting next week.

    The ban is due to come into force in large stores next year and in small shops in 2013, but both the Tories and Lib Dems said before the election they wanted to revisit the issue.

    DH advisers and Anne Milton, parliamentary under secretary of state for public health, will discuss with colleagues whether the ban would be the best way to discourage teenagers from smoking.

    A decision was expected within the next fortnight, one senior lobbyist said. "There will be two outcomes either it will be scrapped or they will say that they want to think about it some more. If they choose the latter option, there are unlikely to be any more developments until the end of the summer."

    Health groups are also understood to have intensified their lobbying efforts in support of the ban.

    This week, in response to a question from Luciana Berger MP, Milton wrote: "Discussions are taking place across government to decide how best to tackle this issue in the context of our focus on public health and our priorities, given the challenges facing business competition and costs."

    Source: The Grocer, 24 July 2010
    Link: http://bit.ly/b0NvJb

  • Tobacco giant pledges £112m to combat European illegal trade in cigarettes

    One of the world's biggest tobacco companies has pledged £112million towards European efforts to smash the illegal trade in cigarettes.

    British American Tobacco (BAT) is joining forces with the European Commission's anti-fraud office and national enforcement authorities in the 27 EU countries to counter organised crime worth tens of billions of pounds a year.

    The deal was agreed at a signing ceremony on 15th July, two years after BAT approached the commission with plans to step-up the fight against tobacco counterfeiting and smuggling.

    Estimates put annual losses from the smuggling of genuine and counterfeit cigarettes - those with cheap contents and copied brand logos - at around £8.4billion a year.

    Average customs duty and VAT losses from 10 million smuggled cigarettes - the cargo of a 40ft boat - is £1.25million. However, the UK loss would be three times as much because of higher than average tobacco taxes.

    Algirdas Semeta, European tax and anti-fraud commissioner, said: 'Today's agreement will help greatly in combating the illegal trade in cigarettes and will send a strong signal to criminals that they have both the authorities and industry working against them.'

    Jack Bowles, BAT's director for Western Europe, said: 'The illicit trade in tobacco is organised crime and is the number one fraud perpetrated in Europe.

    'This is costing member state governments and businesses tens of billions of pounds every year. This is happening at a time when governments around Europe can ill afford to be losing these revenues.'

    He said 75 billion cigarettes were smuggled around Europe every year.

    Mr Bowles added: 'To put this into context, 75 billion cigarettes are more cigarettes than are sold in a large EU member state, such as Spain or Poland or the UK. This means that close to 13 per cent of all cigarettes sold in Europe change hands illegally. 'Illicit trade is like an illegal tobacco company having almost 13 per cent of the European market, without obeying any laws.

    'To demonstrate our commitment to this partnership, and our ceaseless determination to reduce and ultimately eradicate this escalating problem, we shall be contributing £112million over 20 years. This will support the commission and the member states as they continue to play the lead role in this fight against illicit trade.'

    BAT is the world's second largest stockmarket-listed tobacco group, and includes Dunhill, Kent, Pall Mall and Lucky Strike among its brands.

    China is the biggest source of counterfeit cigarettes, but significant quantities come from Russia and Ukraine and illegal factories have been found in some EU countries.

    Genuine smuggled cigarettes come from Russia, Ukraine, Moldova and Belarus - countries where prices are so much lower that huge profits can be made smuggling them into higher-priced markets.

    A third concern is the growth of cheap new brands outside the EU, which are then illegally imported and sold. The commission said they are becoming an alternative to counterfeit cigarettes, popular with consumers because of their low prices. In 2008, 5.2 billion cigarettes were seized by EU member states.

    Source: Daily Mail, 16 July 2010
    Link: http://bit.ly/bbSTqB

  • Tobacco manufacturers target major music festivals to reach young audience

    Tobacco companies are using increasingly sophisticated marketing techniques to circumvent the law and promote their brands to young people, according to health experts.

    Cigarette advertising is banned in the EU, but wily tobacco giants are increasingly targeting young people through social networking sites such as Facebook and at major music festivals to create a "buzz" around their products.

    A survey of the major youth-orientated summer festivals held across the UK has revealed that the events have become a key target for tobacco firms. Action on Smoking and Health (ASH) says that they provide powerful marketing opportunities for cigarette manufacturers to establish "a potent but unconscious bond between their brands and the intense experience of the festival".

    Several of the UK's biggest festivals have allowed tobacco firms to sell their products on site in ways that have been condemned by health experts. This weekend's Lovebox festival in east London's Victoria Park, headlined by Roxy Music, is co-sponsored by Imperial Tobacco's Rizla rolling paper, which is exempt from the ban on tobacco advertising. An Imperial spokesman said the brand had sponsored a number of festivals. "It's all part of creating brand awareness and it's entirely legitimate."

    At last year's Latitude festival in Suffolk, only Marlboro cigarettes could be sold. The cigarettes were available in black-and-red kiosks that lit up at night and were sold by young, attractive staff wearing "Marlboro Red" T-shirts and sunglasses. Only "special edition" boxes of Marlboro were available from the kiosks, which also offered "festival edition" lighters. This year's festival, which is being held this weekend, has seen a similar exclusive deal signed with John Player Special cigarettes, manufactured by Imperial Tobacco.

    At last year's Big Chill in Herefordshire, five large cigarette stands that were illuminated at night sold only brands produced by JTI, which include Camel, Benson and Hedges and Amber Leaf. The stands, which sold limited edition packs and cigarettes at a reduced price, were staffed by "promotion girls" dressed in white uniforms. Festival "packages" were also available, containing two packs of cigarettes in a box that came with a lighter and glow stick and could be worn around the neck. Cigarette "stub tidys" bearing the JTI and Gallaher tobacco company brands were given away, while customised camper vans sold rolling tobacco.

    At the Wakestock festival in Wales in 2008, reduced-price cigarettes, again manufactured by JTI whose brands also include Silk Cut, were promoted in stylish porthole displays, erected on a split-level stand staffed by attractive female sales staff dressed in pink and white uniforms.

    "The tobacco industry needs to recruit new young smokers as their existing customers either quit or die," said Deborah Arnott, chief executive of ASH. "Their problem is that all but a few smokers start by the age of 18 and by that time they have made the brand choice that will last many of them a lifetime. Most forms of advertising are illegal in the UK, so the industry plays a clever game staying at the edge of the law, but in truth they are engaged in a fierce battle to capture the illegal teen market."

    According to a survey of more than 10,000 adults in England, commissioned by Ash, six out of 10 parents want to ban tobacco marketing at festivals.

    The battle to win young hearts and minds is also being waged in cyberspace. Research by an Australian academic, Becky Freeman, of Sydney University, published in the international journal Tobacco Control, found that employees of British American Tobacco (BAT) were using Facebook to promote Dunhill and Lucky Strike.

    Freeman notes: "Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items." The employees are working in countries that have ratified bans on tobacco advertising, raising questions about whether their actions could be challenged in the courts.

    Outside Europe, the promotion of cigarettes to young people is more blatant. The Camel brand has sponsored the Creamfields festival in Buenos Aires. In 2008, the Indonesian unit of Philip Morris International was forced to cancel its sponsorship of an Alicia Keys concert after complaints from anti-smoking campaigners and the singer herself. Last April, American Idol winner Kelly Clarkson came under fire after it emerged that her concert in Jakarta was sponsored by the cigarette brand LA Lights.

    Meanwhile, it has emerged that UK tobacco firms are seeking to overturn new laws that ban cigarette vending machines from pubs and remove tobacco displays from shops and supermarkets, something that would have consequences for underage smokers, who frequently use vending machines to circumvent the law. The laws were passed by the previous government, but the regulations that would have implemented the changes have been blocked after a campaign from cigarette manufacturers which threatened to seek a judicial review.

    The Department of Health has said that, given "the challenges facing business competition and costs", it would give further consideration to "the policy on display of tobacco products and sales from tobacco vending machines".

    Research presented to parliament suggests that 17% of 11- to 15-year-olds who smoke regularly buy cigarettes from vending machines, while a study published in the Journal of Nicotine and Tobacco Research last year found that displays behind shop counters influence young smokers.

    The article claimed the belief that "displays affect smoking initiation by children and may affect smoking behaviour of established smokers is supported by evidence, from reviews of internal documents, of the increasing importance attached to PoS [point of sale] by the tobacco industry and by the increasing tobacco industry resources expended on PoS marketing."

    Source: The Observer, 18 July 2010
    Link: http://bit.ly/cHckoA

  • Total smoking bans in psychiatric inpatient services

    Abstract

    Background: The introduction of total smoking bans represents an important step in addressing the smoking and physical health of people with mental illness. Despite evidence indicating the importance of staff support in the successful implementation of smoking bans, limited research has examined levels of staff support prior to the implementation of a ban in psychiatric settings, or factors that are associated with such support. This study aimed to examine the views of psychiatric inpatient hospital staff regarding the perceived benefits of and barriers to implementation of a successful total smoking ban in mental health services. Secondly, to examine the level of support among clinical and non-clinical staff for a total smoking ban. Thirdly, to examine the association between the benefits and barriers perceived by clinicians and their support for a total smoking ban in their unit.

    Methods: Cross-sectional survey of both clinical and non-clinical staff in a large inpatient psychiatric hospital immediately prior to the implementation of a total smoking ban.

    Results: Of the 300 staff, 183 (61%) responded. Seventy-three (41%) of total respondents were clinical staff, and 110 (92%) were non-clinical staff. More than two-thirds of staff agreed that a smoking ban would improve their work environment and conditions, help staff to stop smoking and improve patients' physical health. The most prevalent clinician perceived barriers to a successful total smoking ban related to fear of patient aggression (89%) and patient non-compliance (72%). Two thirds (67%) of all staff indicated support for a total smoking ban in mental health facilities generally, and a majority (54 %) of clinical staff expressed support for a ban within their unit. Clinical staff who believed a smoking ban would help patients to stop smoking were more likely to support a smoking ban in their unit.

    Conclusions: There is a clear need to more effectively communicate to staff the evidence that consistently applied smoking bans do not increase patient aggression. There is also a need to communicate the benefits of smoking bans in aiding the delivery of smoking cessation care, and the benefits of both smoking bans and such care in aiding patients to stop smoking.

    Wye, P. et al., Total smoking bans in psychiatric inpatient services: a survey of perceived benefits, barriers and support among staff. BMC Public Health 2010, 10:372

    Source: BMC Public Health - 25 June 2010
    Link: http://bit.ly/ac1XLO

  • Trace metal in Indian tobacco products and health implications

    Abstract

    Concentrations of seven heavy metals, viz. Cd, Ni, Pb, Cr, Cu, Fe and Zn were determined in 30 samples of various brands of five different tobacco product types easily available in Indian markets. Three product types cigarettes, cigars and biri (tobacco rolled in dry leaf and smoked without filter) are consumed by smoking while chewing tobacco and snuff are consumed by chewing and sniffing, respectively. The metal content showed smoking and non-smoking type, brand and element specific variations. In the non-smoking type, chewing tobacco samples contained more heavy metals compared to snuff samples. Biri showed minimum metal content compared to cigarettes and cigars among the smoking types. This could be due to the metal enrichment during both chemical and physical processing in finished product; biri being the most raw and cheap product. The intra brand variations also indicate the same as the processing technologies are exclusive and different for each brand. The results are nearly comparable to the existing data with limited exceptions. We suggest that the smoke and ash produced could be significant contributor to metal load in the soil, air and water systems in addition to the adverse human health effects via direct tobacco consumption
     

    Verma, S. et al. Trace metal concentration in different Indian tobacco products and related health implications. Food and Chemical Toxicology Volume 48, Issues 8-9, August-September 2010, Pages 2291-2297

    Source: Science Direct - 26 May 2010
    Link: http://bit.ly/9iAqCg

Events

  • Personalisation and peer support – the mental health education and training agenda

    This conference – the 10th annual event of its kind – will explore the mental health education and training agenda for both personalisation and peer support. This will be done through:

    • Presentations on the key themes of personalisation and peer support

    • Workshops concentrating on examples of education and training initiatives in relation to personalisation and peer support.

    Date: 08 September 2010
    Venue: ORT House Conference Centre, London NW1
    Contact: www.pavpub.com/pavpub/conferences/showfull.asp?Conference=%20190

  • Health in Europe - Ready for the Future?

    Leading experts from business and industry, science and academia, patient organisations/NGOs as well as numerous prominent decision makers in health policy present new ideas and use the EHFG as a platform for the exchange of experiences and opinions at the international level.

    Date: 06 October 2010
    Venue: Gastein, Austria
    Contact: www.ehfg.org

  • Smoke Free Futures: Tobacco Control Conference 2010

    Smoke Free Futures is a two day tobacco control conference that asks what are the next steps we need to be taking to secure tobacco free futures for our children and how do we help the 70% of smokers who say they wish to quit more effectively in the here and now.

    Confirmed workshops and presentations at the Conference include:

    • No Smoking Day – Be the first to find out about NSD 2011
    • Young Tobacco Control Campaigners Tell their Stories
    • Understanding the Framework Convention on Tobacco Control (FCTC) and the Framework Convention Alliance
    • Evaluation of the Ireland Point of Sale Legislation
    • Development of a Tobacco Control Strategy for Wales

    Conference participants will have the opportunity to learn from the successes and challenges faced by successful tobacco control practitioners at this highly interactive conference.

    Date: 11 October 2010
    Venue: Mercure Holland House Hotel Cardiff, Wales
    Contact: www.smoking-conference-wales.org.uk

  • SCTRP Annual Update and Supervision Day

    The annual opportunity for SCTRP graduates to troubleshoot existing practice, update on research, and interact with over 100 practitioners.

    Tutors: P Hajek, R West, G Sutherland, H McRobbie and members of their teams.

    Cost: £235 (£200 plus VAT) Early Bird rate prior to course

    Availability: 100+

    Date: 03 December 2010
    Venue: Park Crescent Conference Centre, 229 Great Portland Street, London W1
    Contact: Janice Rossabi on +44 0208 347 0556 or sctrp@yahoo.co.uk

  • 5th European Conference on Tobacco or Health

     The conference programme will comprise three days of sessions. There are four main programme tracks:

    • Tobacco control policy measures;
    • Tobacco industry strategies and tactics
    • Tobacco treatment;
    • Health education & health communication.  
    Date: 28 March 2011
    Venue: Amsterdam
    Contact: www.ectoh.org