A recently completed sample based study done in Bangladesh claims that the health warning labels describing the harmful effects of tobacco products using text and/or pictures are found to be effective.
Health warnings on cigarette packages are among the most prominent sources of information about the harms of smoking and tobacco use.
Indeed, even in high-income countries where millions of dollars are spent on anti-tobacco mass media campaigns, smokers still report getting information about the risks of smoking from cigarette packages almost as much as from television, and much more than from other sources such as print media.
Therefore, in a country such as Bangladesh, where very little information about the harms of tobacco use appears on television and other broadcast media, warning labels on tobacco packages represent an even more important opportunity for informing the public about the harms of tobacco. Given their tremendous reach and frequency of exposure, health warnings are an extremely cost-effective public health intervention compared to other tobacco prevention efforts such as paid mass media advertising – these came out of a sample-based survey.
Findings from the survey revealed, 98.1% of the respondents opined that they supported the current practice of bothside for pictorial/graphical health warnings (GHW) and 77.5% respondent informed that they thought that the current use of GHW of 50% of the cigarette pack for warnings was good enough to demotivate and reduce the use of tobacco products. Considering up to 50% of the cigarette pack, around 89% were supporting this.
The findings revealed – about 72.7% of the respondents reported that they felt very unpleasant to see the pictorial warning on the tobacco packets (74.1% in urban and 72.7% in rural areas). The survey also reported that the pictorial warning was very realistic to 65.6% of the respondents and extremely realistic to 17.0% respondent (18.8% in rural and 15.3% in urban areas).
The psychological impact of GHW on the respondents was also examined. 13.9% of the respondents were extremely worried and 61.7% were very worried to see the pictorial warning on the cigarette package.
In summary, the study found that the graphical health warnings (GHW) were realistic to provide health-related information and are very effective in creating an unpleasant feeling and sense of worriedness among the smokers to aware them regarding the harmful effects of smoking.
A good news that the study uncovered was 75.8% respondents tried to reduce or quit smoking after seeing the pictorial warning on the cigarette packet. The rate is 76.3% in rural and 75.3% in urban areas. 83.5% respondents reported that they tried to reduce or quit smoking habit to see the pictorial warning. 74.8% recommended to include
GHW in Biri, Gul and Jorda.
Moreover, 64.2% respondents recommended that government should take initiative for mass awareness and 85.5% recommended for more visual media (TV) coverage.
Tobacco treaty has helped cut smoking rates, yet more work is needed
The WHO warns against tobacco use which kills about six million people a year globally and imposes a huge burden on the world economy.
A global tobacco treaty put in place in 2005 has helped reduce smoking rates by 2.5 per cent worldwide in 10 years, researchers said, but use of deadly tobacco products could be cut even further with more work on anti-smoking policies.
In a study published in the Lancet Public Health journal, researchers from Canada’s University of Waterloo and the World Health Organisation (WHO) found that while progress against what they called the “global tobacco epidemic” has been substantial, it has still fallen short of the pace called for by the treaty.
The WHO Framework Convention on Tobacco Control (FCTC), which came into effect in 2005, obliges the 180 countries signed up to have high tobacco taxes, smoke-free public spaces, warning labels, comprehensive advertising bans and support for stop-smoking services.
Smoking causes lung cancer and is a major risk factor for cardiovascular illnesses such as heart disease and strokes, which kill more people than any other diseases.
The WHO says tobacco kills about six million people a year globally and imposes a huge burden on the world economy. Annual healthcare and lost productivity costs for those made ill from smoking are estimated at around $1 trillion.
The study analysed WHO data from 126 countries – 116 of which are signatories to the FCTC – and tracked and compared the implementation of the five key measures from 2007 to 2014 to look at links between strong policies and smoking rates.
It found that, on average, smoking rates dropped to 22.2 per cent in 2015 from 24.7 a decade earlier. But the trends varied, with rates falling in 90 countries, rising in 24 and remaining steady in 12.
Countries that fully implemented more FCTC measures saw significantly greater reductions in smoking rates, the study found. Overall, each additional measure was linked with a drop in smoking rates of 1.57 percentage points – corresponding to 7.1 per cent fewer smokers in 2015 compared with in 2005.
The study was not a full global analysis, since only 65 per cent of countries had the data needed, but it did include countries from all income levels and regions. The researchers also noted that the lower smoking rates could be influenced by factors other than FCTC policy recommendations.
“The data did not allow a detailed analysis of the impact of individual policies,” said Geoffrey Fong of Waterloo University, who co-led the work.
He called for more studies that are specifically designed to evaluate the impact of all FCTC policies and would “help provide guidance to countries about what policies may offer the greatest benefits”.
The Alliance for the Control of Tobacco welcomes a hike in the federal tobacco tax announced this week by the Trudeau government.
Executive Director Kevin Coady says they welcome anything to discourage smoking.
He says the surtax the tobacco manufacturer was paying has been removed, and the consumer tax increased, but it should discourage people from picking up the habit, or force them to cut back.
Statistics Canada earlier this week released numbers showing that this province has the highest rate of tobacco use in the country at 24.4 per cent, and marked increase from the previous survey.
Don’t like the science? Then invent one you do like. It was one of America’s greatest snow jobs, costing millions of lives. And it’s happening again with climate change and this time billions of lives are at stake.
The world is warmer than it’s ever been since records began to be kept in 1880. The Antarctic ice sheet is melting so fast it alone is responsible for 10 percent of the global rise in sea levels. The coral bleaching of Australia’s Great Barrier Reef, a direct result of global warming, is now virtually irreversible.
All this as the Trump administration abandons measures to combat climate change and gives climate change deniers full powers to put the brake on any scientific research devoted to establishing a link between climate change and human activity. Goodbye Planet Earth.
This is the willful corruption of science in the cause of ideology. But we’ve been here before. To understand how this game is played, we can go back to what you could call the foundation of the Liars’ Academy, the professionalization of the crafting of alternative scientific facts.
It’s generally thought that the turning point in establishing a direct link between smoking and cancer came with the U.S. surgeon general’s report of 1964. Drawing on 7,000 scientific studies and the work of 150 consultants, the report demonstrated that the death rate among smokers was 70 percent higher than among non-smokers.
In fact, the first really authoritative warning about smoking came in 1953, when Alton Ochsner, president of the American Cancer Society and the American College of Surgeons, predicted that the male population would be decimated unless steps were taken to reduce the cancer producing content of cigarettes.
At this point any link between smoking and cancer had not been acknowledged by the National Cancer Institute or the U.S. Public Health Service or most of the medical establishment. (As late as 1958 a Gallup survey showed that only 44 percent of Americans believed smoking caused cancer.)
A top R.J. Reynolds executive, Claude Teague, had reviewed the same evidence as Ochsner and reported, “Studies of clinical data tend to confirm the relationship between heavy and prolonged tobacco smoking and incidence of cancer of the lung.”
All copies of Teague’s report were collected and destroyed, and a week after Oschner’s speech six tobacco company presidents met to take stock of the threat now facing them. As a result, they called in John Hill, founder of the public relations firm Hill & Knowlton. What followed was a strategy described by a lawyer as “the industry’s ultimate public relations sham.”
Hill & Knowlton advised the companies:
“There is only one problem—confidence and how to establish it; public assurance and how to create it—in a perhaps long interim when scientific doubts must remain. And, most important, how to free millions of Americans from the guilty fear that is going to arise deep in their biological depths—regardless of any pooh-poohing logic—every time they light a cigarette.”
This marked the beginning of what became, literally, an industrial scale exercise in the promotion of an alternative scientific reality. It involved not just alternative facts but an entire body of false scientific argument to deny that smoking caused cancer. This was the work of an unholy alliance of tobacco company executives, public relations flacks, corporate lawyers, scientists, politicians, and gullible media.
The full extent of the conspiracy was revealed only in 2001, when David Kessler, the former commissioner of the Food and Drug Administration, and relentless foe of the tobacco industry, published his memoir, A Question of Intent.
(Personal disclosure: I was one of a team of researchers who worked with Kessler on the book.)
It is timely to revisit this story because, among other things, it demonstrates that the daily flood of alternative facts from the White House builds on the foundation of Big Tobacco’s model of disinformation. There is no need to compare this with the propaganda machine of Nazi Germany or of any totalitarian state. In its reach and sophistication it is a wholly American achievement.
For more than four decades Big Tobacco had one objective: to maintain the pretense that the link between smoking and cancer remained unproven. In that method it anticipated the entire strategy of climate change deniers, to argue that even if the earth was warming up there was no link between that and human activity. In order to pursue their disinformation campaign the tobacco industry had to produce its own alternative facts—or alternative science.
Hill & Knowlton outlined a four-point strategy to deal with scientific critics: “(a) smearing or belittling them (b) trying to overwhelm them with mass publication of the opposed viewpoints of other specialties (c) debating them in the public arena; or (d) we can determine to raise the issue far above them, so they are hardly even mentioned, and then we can make our case.”
The first step in pursuing this strategy was to set up a body that looked and sounded like an authoritative scientific enterprise, then to staff it with scientists prepared to sell themselves to the mission. It was named the Council for Scientific Research, CTR, and its director was a Harvard-educated cancer researcher of international renown, Clarence Cook Little. He, in turn, recruited similarly illustrious peers to the cause.
All of these supposed experts were satisfied that they could rest their reputations securely on the narrow premise on the “unproven” link. In this they were abetted by lawyers who discovered that when cases against the tobacco industry came to court juries were inclined to believe that smoking was a personal choice. So-called scientific witnesses supported attorneys who argued that “association cannot prove causation.”
“Everyone was molded according to the script,” one industry official told Kessler later as he investigated the record.
Kessler, respectful of C.C. Little’s reputation, could not understand how he could have gone along with the CTR’s strategy. He went through Little’s private papers and found no answer. He did, however, find a letter to Little from Charles Huggins, a Nobel laureate cancer researcher at the University of Chicago. Huggins pleaded with Little: “Please leave the tobacco industry to stew in its own juice…[it] is criminal to promote smoking. It is dastardly. This is the Age of the Hollow Man. Let it not be known as the age when our finest thinkers sell out.”
Eventually the industry decided that the CTR was not as effective as it should have been. In 1964, following the surgeon general’s report, the alternative facts campaign had another instrument, Special Projects. This had no official address, no incorporation papers, no board of directors, no by-laws and no accountability.
In fact, Special Projects marked the ascendancy of lawyers. David Hardy, of the law firm Shook, Hardy & Bacon, began looking for scientists and physicians prepared to testify against the surgeon general’s report before Congress. Special Projects was run by the general counsels of the tobacco companies, supported by Shook, Hardy and the Washington, D.C. law firm Covington & Butling.
Kessler discovered that every decision, every research project, every public presentation, went through lawyers who had one prevailing concern: liability.
Kessler found an industry source who was prepared to talk as long he remained identified only as “Veritas.” Discussing the lawyers involved in Special Projects, Kessler asked, “Where did they cross the line?”
“When you commission the research and know the outcome, that’s fraudulent. When you market that as the truth, that’s evil,” Veritas replied.
The cynicism of the operation could sometimes catch a rooky lawyer unawares. One recent law school graduate working for another law firm, Wachell, Lipton, involved with Big Tobacco pointed out that the industry money flowing to the firm was being “used to purchase favorable judicial or legislative testimony, thereby perpetrating a fraud on the public.”
He asked for guidance from more senior colleagues. There was no record of the response. We are fond of describing America as a nation of laws. Maybe so, but we are also a nation of lawyers, and you get what you can pay for.
Although the industry’s main effort was directed at squashing litigation, there was a more subtle program of “managing the social climate for tobacco use.” The industry always worked hard to recruit young smokers—after all, the market had always to replace the people being killed off by smoking with another generation of initiates. They noticed that anti-smoking campaigns were beginning to work among teens. In response they branded public health advocates as the enforcers of political correctness, even commissioning a theater group to satirize “the new puritanism.”
Kessler discovered that at Philip Morris successful manipulation of the story wasn’t thought to be enough. Part of a top secret plan called Operation Rainmaker was that they should not only shape the story but own the means of delivering it. Notes for a meeting in 1990 said, “If we are to truly influence the public policy agenda and the information flow to the populace, we must be the media…the only way to do this is to own a major media outlet.”
The proposed targets included the Knight-Ridder newspaper chain; the Copley News Service, United Press International and U.S. News & World Report.
This plot never came to pass. But in some cases Big Tobacco didn’t need to buy the media because the media gave them a pass. Perhaps the most egregious example of this was in a surprising place: the newsroom of The New York Times.
For years some of the most rigorously sustained reporting on Big Tobacco had been the work of Philip Hilts in the Washington bureau of the Times. Hilts had a deep grasp of scientific detail and a passion for pursuing the secrets of how the ingredients of cigarettes were manipulated to create addiction. After a lot of digging Hilts discovered that in Philip Morris’s Benson & Hedges brand there had been a significant rise in the levels of nicotine. Company research had described these levels as “optimum.”
Following publication of the Benson & Hedges story, Philip Morris executives went ballistic and demanded that the paper print a correction. The editors refused, saying that no error had been made.
However, in the Times newsroom some editors had developed a “not another tobacco story” resistance, feeling apparently that there was little left that could surprise. And a week later, Soma Golden Behr, assistant managing editor for national news, called Hilts to New York. Over lunch Behr told Hilts that his tobacco beat was finished and he was reassigned. For two years, until 1999, the Times basically dropped the story.
In that period Alix Freedman of The Wall Street Journal won a Pulitzer for her coverage of Big Tobacco.
Kessler thought Hilts’s reporting had been invaluable and later sought to find out why he had been pulled from the story. He decided that it wasn’t directly a result of the Philip Morris intervention. It was more a dumb misjudgment by editors who thought that the reporter had become too committed to one story.
There is a moral to this, and one I know well from personal experience. Obsession can be the difference between a reporter who sees no further than the news cycle and one who implicitly understands where a story is really going and will stick with it until it gets there. Obsession is good. And when you’re up against alternative facts it’s indispensable.
In his time as FDA Commissioner, under presidents Bush and Clinton, from 1990 to 1997, Kessler was the most formidable opponent ever faced by Big Tobacco. The Supreme Court ultimately refused to accept his case that tobacco should be classified as a drug and therefore that it should be regulated by the agency.
Nonetheless his agency’s investigations finally exposed the lethal secret that the industry had hidden beneath its mountain of alternative facts: cigarettes were, basically, a nicotine delivery system, nicotine led to addiction, everything that could be done to strengthen the dose of nicotine was done, and nicotine addiction killed.
Kessler also proved in chilling detail that the public good can suffer grievous harm as a result of a deliberate and sustained campaign to corrupt science and defer for generations the acceptance of scientific fact. Climate change is a far greater threat than smoking ever was. The ethic of the Liars’ Academy has now been incorporated into main stream politics: the methods of denial haven’t changed, but the stakes are now so much higher. And, as with smoking, there is no concern for future generations, just a greedy defense of the indefensible.
The state Senate has approved raising Oregon’s minimum age for tobacco use to 21.
The bill approved 19-8 on Thursday now heads to the House. If the proposal is eventually signed by Gov. Kate Brown, Oregon would be the third state to increase the legal age for buying and possessing cigarettes and other tobacco products from 18 to 21.
Hawaii was the first state to increase the age, followed by California. Dozens of cities and local jurisdictions have adopted the policy over the years, including Oregon’s Lane County.
The proposal would reduce Oregon’s tax revenue from tobacco by $1.76 million in the upcoming two-year budget, adding slightly to the state’s projected $1.6 billion budget shortfall.
The losses, however, could be covered from proposals to increase tax rates on tobacco.
The legal smoking age in Guam will be 21 next year.
A measure lapsed into law this week raising the legal age to use or purchase tobacco products from 18 to 21 stating Jan. 1, 2018, The Pacific Daily News reported (http://bit.ly/2nPFaIb ). Lawmakers unanimously passed the measure March 9 and the governor took no action, meaning the measure automatically became law.
Last year, the Legislature passed a similar bill to raise the legal tobacco age to 21 but Gov. Eddie Calvo vetoed it, saying was a “willful intrusion into the personal lives and choices of our citizens.”
Adelup Director of Communications Oyaol Ngirairikl said Calvo maintains his stance that residents should be free to choose, but acknowledges that the majority of senators voted in favor of the smoking-age measure, making it immune to a veto.
“Guam’s youth smoking rate is the highest in the nation,” said Speaker Benjamin Cruz on Thursday. “And at a time when tobacco kills more people than alcohol, car accidents and illicit drugs combined, how then can we ignore the fact that doing nothing would not only have protected Big Tobacco, but condemned future generations of young people to disease and death?”
According to the American Cancer Society, smoking rates on Guam have declined in recent years to 27.4 percent, but still remain higher than the national average of 17.5 percent.
Health care officials who supported the measure to raise the smoking age cited a March 2015 Institute of Medicine report that projected tobacco use in the nation to drop by 12 percent if the legal smoking age was raised to 21.
Dutch cancer fighting association KWF is suing four major tobacco companies for aggravated assault resulting in death and forgery. According to the association, the tobacco companies deliberately incorrectly inform smokers about the damage smoking actually causes, AD reports.
KWF is filing charges against the largest tobacco manufacturers in the world – Imperial Tobacco Benelux, British American Tobacco, Philip Morris and Japan Tobacco International.
The association is charging the tobacco companies with forgery because KWF believes they intentionally manipulate the mandatory tests that measure the emission of harmful and addictive substances in cigarettes. In this the KWF points to what they call the “sjoemel cigarette” [tampered cigarette]. These cigarettes have little holes that tests show make smokers inhale less harmful substances. But according to the KWF, this is wrong – smokers partly cover the holes with their fingers, thereby inhaling more harmful substances in practice than the tests indicate.
KWF is suing the tobacco companies with two smoking victims Anne Marie van Veen and Lia Breed and the Youth Smoking Prevention foundation.
Last week we learned that President Joko “Jokowi” Widodo verbally rejected a proposal from lawmakers for a new tobacco bill that would increase protection of the industry and production of cigarettes. However, he finally gave written agreement for discussion by government and the legislature about the proposed law.
Smoking and the tobacco industry have long been big business here with well documented impacts on national, family and individual economies, health and welfare. Today I call on activists concerned for the people of Indonesia to reject the proposed tobacco law, which threatens the health and well-being of our people. It is in conflict with prevailing laws on health and other fields.
We must also raise our voices to point to positive action that the government can take to address some key concerns of the President — an increase in revenues and the welfare of tobacco farmers and workers in the cigarette industry.
A review of some basic facts about smoking and tobacco in Indonesia makes clear the importance of acting promptly.
Among the country’s 255 million people, an estimated 65 percent of adult males are regular smokers, making Indonesia the second-largest cigarette market in Asia after China. Furthermore, in Indonesia the rate of smoking among women has increased rapidly in recent years. This threatens not only the health of these women, but that of their babies and children. Smoking while pregnant increases the risk of miscarriage, low birth weight and respiratory problems in children after birth.
A child growing up with a mother or father or both smoking is at risk in multiple ways. Children’s health may be permanently affected by second-hand smoke in the house. Furthermore children may associate smoking with “being adult” and rush to start smoking themselves leading to early, long-term addiction.
Finally, the households of smokers, particularly low-income families, live with cruel competition for family funds between expenditure on cigarettes and expenditure on good nutrition, clothing, school books and basic medical care. Research shows that it is often the basic needs that lose out — a punishment for the whole family that falls particularly hard on children who are building bones, brains and muscles.
As a pediatrician I would like all parents to be disciplined, caring and active in promoting the best possible life chances for each of their children. Yet science and global experience make clear that the addictive nature of cigarette smoking, peer-group pressure among young people and alluring cigarette advertising makes it easy to start lighting up. Later, smokers find it difficult or impossible to shake the habit.
Therefore I argue not only against the proposed bill.
I also suggest four important actions that could eventually help reduce the threat of smoking to people’s health, thus reducing individual and health expenditure, increase revenue, improve the situation of tobacco farmers and help cigarette factory workers.
First, accede to the Framework Convention on Tobacco Control (FCTC). This global public health treaty aims to reduce tobacco-related causes of ill health and death through cutting legal and illegal supply and demand for tobacco, and protection of health and the environment from tobacco-related damage. Having been adopted by 180 of the 193 UN member states, Indonesia is one of only 13 which is not yet a party to the convention.
Second, increase revenues from tobacco and smoking. The expansion of cigarette production and sales in the proposed bill is presented in terms of expansion of employment opportunities and income for the government.
Yet this increase can be achieved without the bill by increasing the price of a pack of cigarettes (20 sticks), now at US$ 1.40, among the world’s lowest. A significant increase in price will automatically increase revenues from taxes and excises, which benefits the national and regional levels.
Increasing the price would both raise revenue and reduce smoking among the young and the poor -meaning lower treatment costs of tobacco-related diseases.
Third, protect and develop tobacco farmers. Since independence, Indonesia has worked to improve its citizens’ productivity, health services and welfare. There is already a law for the protection and empowerment of farmers (Law No. 19/ 2013). Presidential or other government regulations with special focus could fully meet the needs of tobacco farmers.
Also urgent are special efforts to support farmers wanting to transit out of tobacco farming but without the resources for the startup investment, including training, equipment, seeds etc.
Fourth, protect and attend to the welfare of cigarette factory workers. Similar to farmers, there are laws and regulations that could be used to address their special needs as the industry evolves. And it is clear that even if the cigarette industry expands production in line with the proposed law, it would not expand employment, given the industry’s preference for the speed, efficiency and simplicity of mechanized production.
Layoffs of workers and the shift from hand-rolled cigarettes to mostly mechanized production is already well advanced – 75 percent of kretek (clove-based) cigarettes is now machine rolled. Thus the new law would unlikely provide any significant new employment or support for workers displaced by mechanization.
So is the proposed tobacco bill needed to raise revenues and protect agricultural and factory workers in the industry? No. If we are concerned about the people, their health and well-being, the proposed tobacco bill is clearly unnecessary!
The writer is presently leaders’ envoy and board chair for the Asia Pacific Leaders’ Malaria Alliance (APLMA). She served as health minister (2012-2014) and chair of the Global Fund to Fight AIDS, Tuberculosis and Malaria (2013–2015)
SMOKERS will be banned from lighting up in a Maldon town centre street from next month, it has been announced.
Shoppers will no longer be able to smoke outside Bright’s Path, the row of boutique businesses off Maldon High Street, from April 1. Vaping will still be allowed.
The shopping area features independent businesses for several years such as Mrs Salisbury’s Famous Tea Rooms, Chameleon Jewellery, Sew In Pressed, Rock Hard Candy and newcomer Little Poppets’ Baby Boutique.
Owner Mark Salisbury said statistics showing tobacco sales in the UK were at the lowest in recorded history meant now was the right time for the ban on the privately owned area.
He said: “We’ve been really keen on the idea for some time now, as we have a great deal of outdoor space.
“Our client range has a lot of mothers with young children and families, many of whom are not a fan of the effects of many people smoking when sitting out here.
“This may prove controversial and frustrate some people, but with the summer season approaching we’re going to have more people coming along to sit outside, and when the majority of our clients support the idea, we feel it’s the best time to do it.”
Mr Salisbury also owns the Continental Café further up the High Street which also has an outdoor seating area, where smoking will still be allowed.
He added: “With the news the government brought out the sales are the lowest that they have ever been, we felt if we’re going to do it, it’s now or never.
“The Continental will still allow smoking, and we’re allowing vaping in Bright’s Path, but my wife and I reached the stage where we feel enough is enough and we’re pushing through with it.”
Julie Ciniglio, of Maldon Business Association, welcomed the move.
She said: “I can’t see why this would be anything but a good thing.
“We’re blessed with local independent businesses in Maldon, and the decision to ban smoking like this rests with the business owner and the voice of their clientele.
“There are still a lot of smokers around the town who may have something to say about it, but if they have support from most of their customers then it could prove successful.
“It could even work as an incentive for frequent High Street users who don’t like smoking to go to Bright’s Path more often as a place to get away.”
Come Jan. 1, 2018, only adults age 21 and older will be allowed to legally purchase and use tobacco and e-cigarettes on Guam.
Lawmakers unanimously passed Bill 9-34 on March 9. Without any action from the governor, the measure lapsed into law this week, raising the legal age to use tobacco products from 18 to 21.
Speaker Benjamin Cruz, D-Tumon, issued a statement Thursday on the passage of his measure.
“Armed with facts instead of fear — young people, health care professionals and countless community advocates persisted, and, because of their work, this bill is now law,” Cruz said.
Adelup Director of Communications Oyaol Ngirairikl said while the governor maintains his stance that residents should be free to choose, he also recognizes that a majority of the senators voted in favor of the measure, making it veto-proof.
Last year the Legislature passed a similar bill to raise the legal tobacco age to 21, but Calvo vetoed it, saying the bill was a “willful intrusion into the personal lives and choices of our citizens.”
During session earlier this month, senators amended the bill to double the fines for violators who sell tobacco to those not of legal age to use tobacco products.
Businesses that sell tobacco or e-cigarette products also must update posted notices alerting customers that tobacco products cannot be sold to people under 21 years old.
“Guam’s youth smoking rate is the highest in the nation,” Cruz said. “And at a time when tobacco kills more people than alcohol, car accidents and illicit drugs combined, how then can we ignore the fact that doing nothing would not only have protected Big Tobacco, but condemned future generations of young people to disease and death?”
‘Make a difference’
The American Cancer Society Cancer Action Network also applauded the new law.
“We believe it will make a difference in the lives of our youths by helping to spare them a lifetime of addiction from tobacco use, and therefore tobacco-related disease and death,” said Cathy Rivera Castro, the network’s ambassador constituent team lead.
Smoking rates in the island have declined in the last few years, but remain higher than the national average, according to the American Cancer Society. The smoking rate here is 27.4 percent, higher than national average of 17.5 percent, the organization said in its statement. And one in three local high school students uses electronic cigarettes, it said.
Health care professionals who supported Bill 9-34 cited a March 2015 Institute of Medicine report that projected tobacco use in the nation to drop by 12 percent if the legal smoking age was raised to 21.