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ASH News and Events Bulletin - 16-31 May 2008

Tobacco News

DH to consult on new tobacco control strategy

The Health Secretary, Alan Johnson, has announced that the Government is to launch a public consultation on the next stage of tobacco control. Interviewed on the BBC’s Andrew Marr politics programme on Sunday (25 May) Mr Johnson welcomed proposals by the Scottish Parliament to ban the display of tobacco products at the point of sale and said that similar measures would be included in the public consultation for a tobacco control strategy covering England, Wales and Northern Ireland.

Other measures that are expected to be included in the consultation include a ban or tighter restrictions on cigarette vending machines and minimum pack sizes – ending the sale of packs of 10.

Commenting on the need to further clamp down on tobacco promotion, Mr Johnson said: "Younger people are more influenced by advertising. Two hundred thousand kids under 16 start smoking every year and their chances of a premature death from smoking are three times higher than if they had started smoking in their twenties."

ASH Director, Deborah Arnott, said: "The Government is to be congratulated for launching this ambitious consultation on a comprehensive new strategy to drive down smoking so soon after successfully implementing smoke free legislation. We welcome the focus on protecting children, as two thirds of all smokers start smoking before they reach the age of 18, significantly increasing their risk of dying from cancer.

"Smoking is still by far the major cause of preventable death and disease, exacerbating health inequalities and killing more people each year than alcohol, obesity, road accidents and illegal drugs put together. Reducing smoking, especially among the most disadvantaged in society, continues to be the number one priority if we are to significantly improve public health."

The Liberal Democrat health spokesman, Norman Lamb, said: "It is vital that the Government cracks down on underage smoking and access to cigarettes for youngsters. Vending machines are the key outlet which must be controlled and it's taken too long to address the issue."

"However, any measures taken must be evidence-based," he added. "There is a risk that Labour's addiction to headline-grabbing could lead to measures that are gimmicky, contradictory and would fail to prevent sales to underage smokers."

A spokesman for the British Retail Consortium, which represents all levels of retailers, added: "We think this will make no difference at all to people taking up smoking or the habits of existing smokers but it will impose costs of thousands of pounds to pay for shopfitting."

The Independent 26/5/08
http://www.independent.co.uk/news/uk/politics/the-last-gasp-health-secretary-signals-new-smoking-curbs-834296.html

EU Parliament approves tobacco growing subsidies until 2013

The European Parliament has approved the so called Berlato Report, which proposed an extension of subsidies for the producers of raw tobacco up to 2013.

The controversial report, which also provides for the increase of EU funds for information campaigns against smoking, was approved with 379 votes in favour, 244 votes against, and 14 abstained.

The 2004 EU reform of the tobacco production sector provided for the gradual abolishing of the tobacco subsidies in the Union between 2006 and 2010.

Currently 5% of all funds are transferred to the EU "Tobacco Fund" to finance anti-smoking campaigns. The Report of the Italian MEP Sergio Berlatto proposes 6% from all funds until 2013.

The decision of the EP contrasts with the policy of the European Commission, which favours abolishing all tobacco production subsidies after 2010.

The EP debate showed the conflicting interests of the northern EU states and those from Eastern and Southern Europe, who are the Union's tobacco producers, and who argued for the extension of the tobacco subsidies.

The northern states maintain that the support for tobacco production contradicts the EU policy for limiting smoking.

The EU is the largest importer of tobacco in the world, but ranks only fifth among the world's tobacco producers after China, Brazil, India, and the USA.

The EU states producing tobacco are Bulgaria, Belgium, France, Germany, Greece, Italy, Spain, Poland, and Portugal.

Source: Novinite 21 May 2008

Mental health patients have no “right to smoke” judge rules

Is there a human right to smoke in your own home? That was essentially the question the High Court was asked to answer this month in a case brought by high-security mental health patients at Rampton hospital (Nottingham). The public places smoking ban, introduced by the Health Act 2006, also allowed for exemptions in certain areas. The private rooms of patients at Rampton are excluded until July 1 this year. After that the NHS has decided to introduce a total ban at the hospital. Other high-security hospitals have already introduced a total ban.

The claimants in the case relied on ministerial statements that it was not the intention of the Government to prevent people from smoking in their own homes. It was argued that as the average stay of a patient at Rampton is more than eight years, it was right to see the hospital as the home of patients. The court was prepared to accept the argument. However, that was just about all that the court did accept.

The claimants had to show that their right to respect for private life and home was being interfered with by the ban, so as to bring them within article 8 of the European Convention of Human Rights. The court accepted that the scope of the right in article 8 is a wide and diffuse one and difficult to define. However, the judges said that they were not persuaded that article 8 “imposes a general obligation on those responsible for the care of detained people to make arrangements enabling them to smoke”.

They went on to say that “whether it is put in terms of moral integrity, identity or personal autonomy, no general right for mental patients to smoke, or general obligation to permit smoking, arises”. That was really the end of the argument, but the court went on to consider other aspects of the case as well. There was no convincing evidence presented to suggest that giving up smoking would worsen the condition of mental patients. The policy of banning smoking for general health reasons was a legitimate one for the Government and the health service to pursue. Arguments about the sanctity of personal liberty based on the philosophy of J.S. Mill were rejected.

It was also noted that prisoners will continue to be entitled to smoke in prisons, but the court was doubtful as to whether the claimants could say that they were being discriminated against on the basis of their status as detained mental patients. So it looks as though the patients at Rampton will be stubbing out at the end of next month. However, an appeal is planned with hopes that the Court of Appeal will be able to consider the case before the total ban comes into place.

The Times, 27 May 2008
http://tiny.cc/3YLh5

Parliamentary News

PQ - Tobacco subsidies

John Spellar: To ask the Secretary of State for Environment, Food and Rural Affairs (pursuant to the answer of 12 May 2008, Official Report, columns 1341-2W, on tobacco: EU grants and loans) what steps he is taking to persuade other EU member states to reduce levels of subsidy to tobacco producers.

Jonathan R Shaw (Parliamentary Under-Secretary (Marine, Landscape and Rural Affairs) and Minister for the South East), Department for Environment, Food and Rural Affairs; Chatham & Aylesford, Labour): As a non-producer, the UK has concerns about the cost and health implications of the tobacco regime. Subsidies are at odds with the European Community sponsored Europe Against Cancer programme and UK health objectives. The UK has always been critical of the regime.

Ideally the UK would prefer to see it abolished, and so favour progressive disengagement from the sector. Following the 2004 reform, direct support for tobacco production will be progressively brought to an end by 2010. As the majority of member states are tobacco producers it was extremely difficult to secure earlier reform of the regime. However the UK is pleased that the link between production and subsidy will finally be brought to an end.

Subsidies in 2007 were €335.5 million, a reduction from the €810.9 million granted in 2006.

Hansard Source – 21/05/08 Column 351w
http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080521/text/80521w0014.htm#08052187000283
_{Ed Note: This PQ was answered prior to the European Parliament’s approval of the Berlato report cited above.}

Launch of National Institute for Health Research

Seven new partnerships between NHS organisations and leading universities will receive a total of £64 million to conduct research and improve care in major conditions including heart disease, stroke, diabetes and obesity, Public Health Minister, Dawn Primarolo has announced.

The new NIHR (National Institute for Health Research) Collaborations for Health Research and Care were selected by an independent international selection panel and will start work on 1 October 2008.

Each Collaboration will bring together universities and their surrounding NHS organisations to test new treatments and new ways of working in specific clinical areas, to see if they are effective and appropriate for everyday use in the health service. Where potential improvements are identified, the collaborations will help NHS staff to incorporate them into their everyday working practices, so that patients across the local community receive a better standard of healthcare.

Dawn Primarolo said:

"This new funding will help to improve health outcomes for patients across England, with particular emphasis on conditions that cause chronic distress to patients and are a significant issue for the NHS to manage."

Professor Sally C. Davies, Director General of Research and Development, Department of Health said:

"The NIHR Collaborations for Health Research and Care represent an exciting and innovative partnership between universities and the NHS. They will undertake high quality applied health research and develop new ways of translating research findings into improved outcomes for patients. They will be conducting this work at the front line of the NHS so that the benefits and findings from research can be swiftly incorporated into routine clinical practice."

Further information about NIHR CLAHRCs is available here.

Parliament Today, 27 May 2008

Industry Watch

Imperial Tobacco makes offer for Logista

Imperial Tobacco plc has announced the filing of is offer for any shares in Logista not owned by Altadis, the current owner of nearly 60% of Logista’s shares.

Logista is one of the leading logistics operators for the tobacco industry handling the document, book and publication sectors in Portugal and Spain. It also offers storage and stock management, invoicing, collection management, warehousing, product and facility insurance, distribution and return services.

Tobacco International, March 2008

Recent Research

Changes in smoking among mental health patients on admission to psychiatric unit

Abstract

Smoking and withdrawal from smoking complicates the assessment and treatment of mental illness. We aimed to establish whether psychiatric inpatients smoke different amounts after admission than beforehand and, if so, to find out why. Forty-three inpatients on a working age adult psychiatry ward completed self-report questionnaires about smoking habits. Those who smoked a different amount after admission had a follow-up interview to find out why they thought this had occurred. The interview incorporated qualitative and quantitative aspects which were analysed accordingly. Fifty-six percent of participants were smokers before admission, rising to 70% afterwards. Of the smokers, 17% smoked less after admission, and 63% smoked more. The average number of cigarettes smoked per person per day increased from five to thirteen. The main reasons for smoking more were boredom, stress and the wish to socialise.

Ker S, Owens D. Admission to a psychiatric unit and changes in tobacco smoking. Clin Pract Epidemol Ment Health. 2008 May 6;4(1):12 [Epub ahead of print]

http://www.cpementalhealth.com/content/4/1/12
http://www.cpementalhealth.com/content/pdf/1745-0179-4-12.pdf

Childhood exposure to secondhand smoke and risk of serious infections

Abstract

Background: Second-hand smoke (SHS) exposure is a modifiable cause of ill health. Despite the smoking ban in public places introduced in Hong Kong in 2007, infants and children continue to be exposed within the home.

Aims: To determine the critical windows of SHS exposure and the duration of its impact on serious infectious morbidity in the first 8 years of life.

Methods: The Hong Kong ‘‘Children of 1997’’ birth cohort is a prospective, population-based study of 8327 children comprising 88% of all births in April and May 1997, of whom 7402 (89%) were followed up until their eighth birthday in 2005. We used multivariable Cox regression to assess the relation between postnatal SHS exposure and risk of first admission to public hospitals (together accounting for .95% total bed-days overall) for respiratory, other and all infections from birth to 8 years of age, for all individuals and for vulnerable subgroups.

Results: Overall, household SHS exposure within 3 metres in early life was associated with a higher risk of admission for infectious illness up until 8 years of age (hazard ratio 1.14, 95% CI 1.00 to 1.31), after adjustment for sex, birthweight, gestational age, feeding method, maternal age, highest parental education and proxies of preferred service sector. The association was strongest in the first 6 months of life (HR 1.45, 95% CI 1.15 to 1.83). In vulnerable subgroups such as premature babies, the association held through to 8 years of age (HR 2.00, 95% CI 1.08 to 3.72). Infants exposed to SHS in the first 3 months of life were most vulnerable to infectious causes of hospitalisation.

Conclusion: Household SHS exposure in early infancy increases severe infectious morbidity requiring hospital admission. Reducing SHS exposure in infants and particularly in more vulnerable infants will lower the bed days burden due to infectious causes.

Kwok MK et al. Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong’s ‘‘Children of 1997’’ birth cohort. Tobacco Control. Published Online First: 27 May, 2008

http://tobaccocontrol.bmj.com/onlinefirst.dtl

Events and Publications

Events

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.
See www.uknscc.org for more information.

5 July – RCP Public Open Day to celebrate 60th anniversary of the NHS
Admission free. Includes information on medical education and training, guided tours of the building, and the history of medicine. Open 11am – 40pm.
Details: www.rcplondon.ac.uk

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

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