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HOW TO REPORT A SMOKING OFFENSE IN HONG KONG

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PM Thailand facing USD 2.8 billion in fines

Philip Morris Thailand was charged with underpaying import duty on cigarettes shipped from Indonesia, accusations that come one year after similar charges were filed over Philippine shipments, company documents show.

http://www.tobaccojournal.com/PM_Thailand_facing_USD_2.8_billion_in_fines.54073.0.html

Philip Morris International’s (PMI) Thai subsidiary faces fines totalling THB 100.6 billion (USD 2.85 billion) in the two cases, PMI said in its annual report filed with the US Securities and Exchange Commission. The latest charges filed on 26 January in Bangkok Criminal Court concern cigarette imports from Indonesia between 2002 and 2003, the document shows. The Public Prosecutor is seeking fines of THB 19.8 billion. A procedural hearing is scheduled for April.

A year ago, PM Thailand was charged over cigarette shipments from the Philippines between 2003 and 2007. Fines in that case amount to THB 80.8 billion. Trials are scheduled to begin late this year, the PMI filing shows.

Plain packs coming in 2020

Parliament unanimously approved a law to ban advertising for tobacco products and require uniform packaging from 2020, Reuters reported.

http://www.tobaccojournal.com/Plain_packs_coming_in_2020.54074.0.html

Slovenia joins countries like Australia and the UK in requiring a standard colour and branding on tobacco packaging. Roughly one-in-four Slovenians aged 15 to 64 smoke. Health Minister Milojka Kolar Celarc reportedly said the country wants to reduce the smoking rate to below 5 per cent of the adult Population.

Designing the Tobacco End Game

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Shisha bars to be banned

The government soon will announced a complete ban on commercial use of shisha to protect the country’s youth, according to the Pakistan Observer.

http://www.tobaccojournal.com/Shisha_bars_to_be_banned.54070.0.html

Shisha sales and hookah use in bars, cafes and lounges would cease. Shisha sales would be banned in bazars, the Observer said. Authority for the expected ban from the Ministry of National Health Services, Regulations and Coordination is contained in the Prohibition of Smoking and Protection of Non-smokers Health Ordinance of 2002, the newspaper said on its website.

PMI, BAT units fined KRW 300 billion for hoarding

The Korean affiliate of Philip Morris International (PMI) and a British American Tobacco (BAT) subsidiary were fined a combined KRW 300 billion (EUR 239 million) for hoarding, the Yonhap news agency said.

http://www.tobaccojournal.com/PMI_BAT_units_fined_KRW_300_billion_for_hoarding.54071.0.html

The companies were accused of building up inventories in advance of a 2015 hike in excise duties. Sale of the hoarded cigarettes after January, 2015, allowed the companies to avoid tax on the profits, according to Yonhap. PM Korea was fined KRW 218 billion and BAT Korea KRW 89 billion, Yonhap reported. The ruling has been appealed, the news agency said.

Court upholds NT$5 million fine on British tobacco company

http://focustaiwan.tw/news/asoc/201702020020.aspx

The Taipei High Administrative Court on Thursday upheld a NT$5 million (US$160,800) fine imposed by Taipei City government on a U.K.-based tobacco company.

Imperial Tobacco received the fine in 2015 for violating the Tobacco Hazards Prevention Act, after the company was found to have invited consumers to try out one of its cigarette products, as part of a marketing survey.

Imperial Tobacco filed a case with the Taipei High Administrative Court challenging the fine.

The court on Thursday ruled in favor of Taipei City government, after determining that Imperial Tobacco did indeed violate the provisions of the Tobacco Hazards Prevention Act.

The case can be appealed.

(By Liu Shih-yi and Y.F. Low)
ENDITEM/AW

Smoking Costs Nearly 2% of World’s GDP, Tobacco Control Measures Needed

http://www.news18.com/news/business/smoking-costs-nearly-2-of-worlds-gdp-tobacco-control-measures-needed-1344166.html

Smoking consumes almost six per cent of the world’s total spend on healthcare and nearly two per cent of global GDP, a new research has found.

In 2012 the total cost amounted to $1,436 billion, with nearly 40 per cent of this sum borne by developing countries. The four BRIC countries — Brazil, Russia, India and China — accounted for 25 per cent of it, the findings showed.

“These findings highlight the urgent need for all countries to implement comprehensive tobacco control measures to address these economic costs,” the researchers said.

The detrimental impact of smoking on national health systems and economies has been widely studied since the 1960s, but most of these studies have focused exclusively on high income countries, the researchers noted.

So Mark Goodchild from World Health Organization (WHO) and colleagues wanted to include low and middle income countries to come up with more accurate estimates of the total global cost.

And so they included data from 152 countries representing 97 per cent of the world’s smokers.

They used the ‘cost of illness’ approach, first devised in 1960. This divides the economic impact of an illness into direct costs, such as hospital admissions and treatment, and indirect costs representing the value of productivity lost to death and disability in current and future years, for a given year.

The direct and indirect costs are then added up to provide the overall societal cost, usually expressed as a percentage of annual gross domestic product (GDP).

The researchers used data from sources such as the WHO and the World Bank to uncover information on the proportion of ill health and death attributable to smoking, national employment rates, and GDP for each of the 152 countries, to inform their calculations.

These showed that in 2012, diseases caused by smoking accounted for 12 per cent (2.1 million) of all deaths among working age adults aged 30-69, according to the study published in the journal Tobacco Control.

This figure included 1.4 million adults who would have been in the workforce.

The number of working years lost because of smoking related ill health added up to 26.8 million, 18 million of which were lost to death with the remainder lost to disability.

In terms of health spend attributable to smoking, this totalled $422 billion, equivalent to nearly six per cent of the global total.

The researchers pointed out that their calculations did not include the health and economic harms caused by second hand smoke or smokeless forms of tobacco, and that their estimates of lost productivity applied only to those who were economically active.

Bedford lost £14m last year due to smoking breaks

Figures released this week show smoking costs Bedford borough’s economy almost £34million a year.

But the biggest cost to the economy is not early deaths (£8.79million), smoking-related disease (£4.25million) or lost productivity because of sick days (£2.48million), says Action on Smoking and Health (ASH).

Instead the big cost is from people taking smoking breaks – reckoned to have cost Bedford firms nearly £14million last year because of lost productivity.

Councillor Louise Jackson, portfolio holder for public health, said: “Both councils and the NHS are experiencing severe funding pressures so these costs are not sustainable.

“Smoking remains the single largest cause of preventable death and illness in Bedford Borough, and the council provides free advice and support to help smokers to stop.

“People who use the stop smoking service are up to four times more likely to quit and last year we helped more than 700 people to successfully stop.

“For advice and support call 0800 013 0553.”

Deborah Arnott, chief executive of ASH, said: “We know that most local authorities remain committed to reducing smoking but key services are under threat from public health funding cuts.”

http://www.bedfordtoday.co.uk/news/bedford-lost-14m-last-year-due-to-smoking-breaks-1-7801719

One Way e-Cigarettes May Up CV Risk: Altering HR Variability

http://www.medscape.com/viewarticle/875253

Habitual e-cigarette use may increase the risk of cardiovascular disease by shifting the cardiac autonomic balance toward greater sympathetic activity and increasing oxidative stress, according to new research[1].

“The central message for cardiologists from our study is that habitual e-cigarette use is associated with altered heart-rate variability in the same pattern seen in tobacco cigarette smokers,” Dr Holly R Middlekauff (David Geffen School of Medicine, University of California, Los Angeles) told heartwire from Medscape.

“This pattern of heart-rate variability has been associated with increased risk of myocardial infarction and sudden death in patients with heart disease, as well as in populations without known heart disease. Furthermore, habitual e-cigarette use is associated with increased susceptibility to oxidative stress, a critical component in the development of atherosclerosis,” she said.

Middlekauff and colleagues conducted a study involving 23 self-identified otherwise-healthy e-cigarette smokers and 19 otherwise-healthy nonusers between 21 and 45 years old in 2015 and 2016.

Using electrocardiography and blood tests, they analyzed heart-rate variability by high-frequency component, which signals vagal activity, low-frequency component, which mixes vagal and sympathetic activity, and the ratio of low frequency to high frequency, which reflects the cardiac sympathovagal balance.

The researchers found the high-frequency component to be significantly decreased in e-cigarette users compared with nonusers (standard error of the mean [SEM], 46.5 nu vs 57.8 nu; P=0.04). They found the low frequency and the low–to–high-frequency ratio to be significantly increased (mean [SEM] 52.7 nu vs 39.9 nu; P=0.03; mean [SEM] 1.37 vs 0.85; P=0.05) in e-cigarette users, which they write as being consistent with sympathetic predominance.

They found plasma cotinine levels to be significantly related with each heart-rate variability components, inversely to high frequency (P =0.04) and directly to low frequency (P=0.03) and low–to–high-frequency ratio (P=0.03).

They also found LDL oxidizability to be significantly increased in 12 e-cigarette users compared with 18 nonusers (mean [SEM] 3801.0 U vs 2413.3 U; P=0.01). Paraoxonase-1 tended to be lower in e-cigarette users, which they write as being consistent with less protection against oxidative stress.

The researchers pointed out that both increased cardiac sympathetic activity and increased oxidative stress are known mechanisms of how tobacco smoking increases the risk of cardiovascular disease.

“We can conclude that habitual e-cigarette use is associated with physiologic effects. Nonetheless, we cannot confirm causality on the basis of this single, small study; further research into the potential adverse cardiovascular health effects of e-cigarettes is warranted,” the researchers write in an article published online February 1, 2017 in JAMA Cardiology.

Middlekauff said cardiologists should be telling their patients, “E-cigarettes have real, physiologic, adverse effects. If you don’t already smoke tobacco cigarettes, don’t start using e-cigarettes. They are not harmless.”

As for further research, she added, “We need to know whether the cardiac risks associated with e-cigarettes are as great as those associated with lethal tobacco cigarettes. We need to know which component of the e-cigarette aerosol is driving these adverse physiologic effects.”

In an accompanying editorial[2], Dr Aruni Bhatnagar (University of Louisville, KY) writes that the nicotine in e-cigarettes “is a strong vasoactive drug that can profoundly affect cardiovascular function and health. . . . It has been shown that smoking e-cigarettes increases heart rate as well as diastolic and systolic blood pressure to levels comparable with those observed with conventional cigarettes.”

He praised the researchers involved in the new study: “Such investigations are critical for evaluating how harmful e-cigarettes are and whether their widespread acceptance will decrease the incidence of cardiovascular disease or, by renormalizing smoking and promoting nicotine addiction, erode public-health gains made by evidence-based tobacco control and regulation.”

Outside supporters of this research included the American Heart Association, the National Institute of Environmental and Health Sciences, and the Irma and Norman Switzer Dean’s Leadership in Health and Science Scholarship program. The authors and editorialist reported no relevant financial relationships.

Stub it out: Smoking challenge for hospitals in Wales

On a crisp afternoon a group of school children stand outside Prince Charles Hospital holding their handmade no smoking posters.

http://www.bbc.com/news/uk-wales-38692344

“Please don’t smoke outside our hospitals”, they shout in unison.

As ambulances pull up outside the Merthyr Tydfil A&E department, the 10 and 11 year-olds watch as patients and visitors light up, puffing smoke into the air.

“We’ve seen a number of people smoking next to no smoking signs”, their teacher Kelly-Anne Crane said.

In the last six months alone 783 smokers at Prince Charles and Royal Glamorgan hospitals, in Llantrisant, have been asked to stub it out by security guards.

Cwm Taf University Health Board – who manage the sites – say they are doing everything they can but people have a “total disregard” to the signs plastered across their NHS grounds.

And they are not alone. While all seven health boards in Wales have smoke free policies in place they say they are “powerless” to stop people lighting up, as they are not yet backed by legislation and so smokers are not breaking any laws.

The Public Health Wales Bill – which is currently going through the Assembly for the second time – would make it illegal to smoke on hospital grounds, giving the board’s the much needed legal backing to issue fines to smokers flaunting the rules.

The Welsh Government said the bill will “build on existing voluntary smoking bans in order to aid enforcement”.

Betsi Cadwaladr University Health Board – who manage hospitals across north Wales – said the public “do not respect” requests to not smoke on their sites.

They said that without legislation to back them up they had to rely on the “courtesy and consideration of smokers” not to light up, and despite extensive signage and recorded messages triggered a cigarette is sensed nearby, people still ignored their policy.

A spokesman said: “We do encourage members of staff to challenge smokers who are causing a nuisance but unfortunately this can provoke a negative or aggressive reaction, which understandably makes busy colleagues reluctant to continue asking people to put out their cigarettes or move away from entrances.”

It is not just the contradictory image of patients in dressing gowns smoking outside the place they are being treated which concerns health boards and bodies like the British Medical Association (BMA).

Health boards have concerns about smoke drifting through windows into wards, passive smoking, and the impressionability of the growing number of young people receiving treatment on their sites.

Cwm Taf are now hoping the words of children will make people think twice about smoking outside their buildings.

Local school children like those from Cyfarthfa High, have designed special posters detailing the dangers of smoking.

If the posters fail the board is considering introducing push-button tannoys – which staff, patients and visitors can trigger if they spot someone defying the rules – which could use children’s voices to tell smokers to stub it out.

Dr Chris Jones, chair of Cwm Taf, said: “Hospitals are for people who are sick and smoking causes illness.

“I don’t think the health board is enforcing anything, we are encouraging people do to the right thing.

“We offer support and advice: it is not about being oblivious to the fact that giving up is difficult, but there is evidence that adults listen to children.”

Hywel Dda University Health Board already has a push-button system at the entrances to their acute hospitals, but said it has not stopped some people.

A spokesman said: “Everyone has the right to breathe fresh air, especially when visiting a healthcare facility, and we regularly receive complaints about people smoking on our sites.

“We understand that visiting a hospital can sometimes be a stressful experience but we expect smokers to adhere to our smoke free policy and they should anticipate being asked to leave our hospital sites if they wish to continue smoking.”

Cardiff enforcement officers challenged 6,708 smokers outside the University Hospital of Wales and University Hospital Llandough, in two years.

Trina Nealon, principal health promotion specialist for Cardiff and Vale University Health Board said hundreds of people were challenged every month.

While there have been no reported cases of verbal or physical abuse against staff challenging smokers, the board said it knows some staff feel uncomfortable challenging visitors and patients who are dealing with stressful situations.

“We are not taking away anything from anyone,” Ms Nealon said, adding that patients were given support to try and quit smoking on admission.

“How we see it is smoking is an addiction, and we are giving people an opportunity to actually give up that addiction.

“Generally speaking people are receptive and they put out their cigarette, understanding that they are in a hospital where people are there to get better and are there to get treated.”

‘Culture change’

Aneurin Bevan University Health Board said that while there had been a significant reduction in smoking at their hospitals “disappointingly there are some people who will continue to smoke despite all the messages.”

Powys was the only health board who said they had little difficulty with smoking – “possibly as a result of only having community hospitals”

While there is hope that the new legislation would help health boards to challenge smokers, they appear to be under no illusion that the threat of fines will stub out the problem for good.

“It may not stop them smoking. We are hoping that it will lead to a culture change and people will accept that smoking in a hospital setting shouldn’t be allowed,” said Ms Nealon.