HEADLINES

• Smoking parents warned of damage to children
• Smokers cost their employers an extra £4,000 a year each, finds research
• Surrey council to continue tobacco investment
• Thieves switch from metal to bulk cigarettes
• Cambridgeshire: Police free to puff on e-cigarettes at work
• Industry survey of GPs reveals that many identify nicotine as a harmful cigarette-smoke component
• Canada: Ontario wins important victory in $50bn lawsuit against tobacco firms
• Australia urges world to stand up to tobacco industry

Smoking parents warned of damage to children

Smokers cost their employers an extra £4,000 a year each, finds research

The study, published in the Tobacco Control journal, found that several factors linked to the habit including absenteeism and smoking breaks resulted in greater costs to businesses.

Surrey council to continue tobacco investment

Thieves switch from metal to bulk cigarettes

Cambridgeshire: Police free to puff on e-cigarettes at work

Industry survey of GPs reveals that many identify nicotine as a harmful cigarette-smoke component

The online survey sought to assess the knowledge, perceptions and attitudes to tobacco and nicotine products of healthcare professionals in the UK and Sweden and to understand what types of advice in relation to the use for alternative nicotine products are being offered to smokers.

Canada: Ontario wins important victory in $50bn lawsuit against tobacco firms

The province is seeking damages dating back several decades in relation to medical treatment costs for lung cancer patients.

Australia urges world to stand up to tobacco industry

CONTENTS

• Tobacco News
• Health Secretary: ‘No decision’ on packaging or alcohol pricing
• UK PM faces pressure over adviser’s links to tobacco company
• EU: Dalli believes OLAF investigation ‘was a set-up’
• Scotland may go it alone on plain cigarette packets
• Wales: Health minister to shelve plans to exempt film and TV performers from smoking ban
• Cigarette butts littering UK beaches doubled in 2012, figures show
• Plain packaging: The last form of cigarette advertising
• The WHO FCTC: the challenge of implementation
• Judith MacKay: self-made scourge of the tobacco industry
• Meet the ‘vapers': E-cigarette craze inspires bizarre new sub-culture
• Parliamentary News
• Parliamentary question: E-cigarettes
• Debate of the Queen’s Speech in the Lords
• Industry Watch
• South Africa: BAT rapped for unfounded advertising
• Recent Research
• Non-smoking hotel rooms fail to protect non-smokers
• Smoking and drinking by English school pupils
• Online smoking cessation help
• Rate of smoking cessation by age, gender and social grade
• Impact of point-of-sale tobacco display bans

EVENTS

• World No Tobacco Day 2013
• ASH Scotland 40th Anniversary Conference: Towards a Generation Free From Tobacco
• Towards a generation free from tobacco
• UK National Smoking Cessation Conference

Tobacco News

Health Secretary: ‘No decision’ on packaging or alcohol pricing

“We haven’t made a decision and when we have made a decision, we shall see if Mr [Nigel]Farage has a smile on his face or not,” Mr Hunt said.

“Just because something is not in the Queen’s Speech doesn’t mean the government cannot bring it forward as law,” Mr Hunt added.

See also:
– Editorial: the government’s cowardly surrender to the tobacco lobby, The Observer
– No 10 accused of ‘caving in’ to cigarette lobby as plain packs put on hold, The Observer
– Tobacco lobby told Government: branding ban will cost you millions, The Independent
– Death is tobacco companies’ business, The Guardian
– Janet Street-Poter: We’ll all have to cough up for Dave’s betrayal on booze ‘n’ fags, The Daily Mail
– David Cameron’s u-turn on cigarette packaging branded ‘weak and pathetic’ by Manchester MP and health experts, Mancunian Matters
– Comment: Big Tobacco’s victory over plain packaging will get more teens hooked, Politics.co.uk
– School students in call for plain packaging of cigarettes, The Northern Echo
– Welsh anti-tobacco group has urged the Government to go ahead with plain cigarette packaging, This Is South Wales
– Will David Cameron stub out plain cigarette packets plan?, International Business Times
– Letter: Plain cigarette packets, The Telegraph
– Teenager calls for Prime Minister to introduce plain cigarette packaging, BBC Radio 1 Newsbeat
– Government has lost “credibility on public health” for inaction on cigarettes and alcohol, campaigners say, BMJ (£)
– NFRN welcomes exclusion of plain packs for tobacco from Queen’s Speech, Talking Retail
– Plain cigarette packaging plans could be axed, health campaigners angry, The Huffington Post
– Cigarette plain-packs setback as ban faces delay, The Times (£)
– Lives will be lost if government scraps standardised cigarette pack plans, The Guardian
– Editorial: Tobacco is a problem to be tackled, not dodged, The Independent
– UK coalition to shelve bold ideas as focus moves to swing vote, The Financial Times (£)
– UK government abandons plain cigarette packaging plan, The Financial Times (£)
– Cigarettes will NOT be sold in plain packaging, Daily Mail
– Smokefree Action Coalition writes to Cameron to urge standardised packs, Daily Star
– Plans for plain cigarette packs scrapped as ‘it’s not a Government priority’, Daily Mirror
– Fury at reports of PM’s cigarette packaging U-turn, The Scotsman
– Plain cigarette packaging U-turn ‘shocking’, claim heath campaigners, Metro
– Cameron stubs out plain fag packet plan, Morning Star
– Plain cigarette packets plans go up in smoke, City AM
– Campaign group urges Government to back plain packaging of tobacco. The Northern Echo
– Standardised cigarette packs urged, The Fulham and Hammersmith Chronicle
– Government denies scrapping plan for plain tobacco packs, The Grocer
– Cameron ‘scraps plain tobacco pack legislation’: reports, Packaging News
– Whitehall smoking claim ‘shocking’, IC Walsall
– British PM backs off cigarette packaging plan, UPI
– Charities ‘extremely concerned’ over standard packs claim, Cancer Research UK
– Imperial Tobacco jumps as U.K. may not alter packs, Business Week

UK PM faces pressure over adviser’s links to tobacco company

Crosby’s lobbying firm Crosby Texter counts as one of its previous clients the tobacco giant British American Tobacco.

Number 10 has declined to comment on how much of an influence Crosby had on the substance of the Queen’s speech but senior Conservative sources have admitted that he played a key role.

[registration required]

See also:
– David Cameron refuses to publish client list of his controversial aide, The Daily Mirror
– David Cameron aide’s links to tobacco industry as Tories ditch plain packs plan, The Daily Mirror
– David Cameron’s top aide’s links to the alcohol industry revealed, The Daily Mirror
– Lobbyist dictating alcohol and tobacco policy, says Labour. London Evening Standard
– Questions for Cameron over Lynton Crosby’s links to alcohol and tobacco firms. New Statesman
– David Cameron under fire from all sides over aide’s links to tobacco and alcohol industries. The Daily Mirror
– MP queries if Cameron aide had role in axing health plans. The Times
– Call for PM to declare if he discussed dropping curbs on booze and cigarettes with aide, The Daily Mirror
– David Cameron’s head of strategy sues Australian minister for libel, The Guardian

EU: Dalli believes OLAF investigation ‘was a set-up’

“Reading through the analysis of the report it confirmed what I have been saying all along that this whole OLAF investigation was a setup,” the former European Commissioner said.

Scotland may go it alone on plain cigarette packets

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Wales: Health minister to shelve plans to exempt film and TV performers from smoking ban

Health Minister Mark Drakeford announced that the proposal, which encountered fierce criticism from health campaigners, would not be going ahead after a lack of support from Welsh Assembly Members.

Cigarette butts littering UK beaches doubled in 2012, figures show

Plain packaging: The last form of cigarette advertising

See also:
– The History Of Cigarette Advertising In The UK, Dr Fox

The WHO FCTC: the challenge of implementation

Judith MacKay: self-made scourge of the tobacco industry

Meet the ‘vapers': E-cigarette craze inspires bizarre new sub-culture

Parliamentary News

Parliamentary question: E-cigarettes

Norman Lamb: There are a number of products on the market which claim to contain nicotine, such as electronic cigarettes, which are widely and easily available but are not licensed medicines. Currently, any nicotine containing product (NCP) that claims or implies that it can assist in giving up smoking is considered by the Medicines and Healthcare products Regulatory Agency (MHRA) to be a medicinal product. This approach has allowed NCPs which do not make such claims to be used and sold without the safeguards built into the regulation of medicines.

The Government is concerned to ensure that an effective, proportionate regulatory framework exists to protect consumers from any electronic cigarette products that fail to meet acceptable standards for quality, safety and efficacy. The MHRA co-ordinated a programme of research to advise on:

an investigation of the levels of nicotine which have a significant physiological effect through its pharmacological action;

the nature, quality and safety of unlicensed NCPs;

the actual use of unlicensed NCPs (excluding tobacco products) in the marketplace;

the efficacy of unlicensed NCPs in smoking cessation; and

modelling of the potential impact of bringing these products into medicines regulation on public health outcomes.

The MHRA is currently bringing to a conclusion this period of scientific and market research with a view to a final decision on the application of medicines regulation soon.

Mr Frank Field: To ask the Secretary of State for Health if he will bring forward proposals to extend existing smoking legislation in the UK to include vapour from electronic cigarettes.

Anna Soubry: While they contain nicotine, the majority of electronic cigarettes do not contain tobacco and so legislation that deals with tobacco does not apply.

The Government have no plans to extend the current smokefree legislation. Smokefree legislation regulates being in possession of any lit substance in a form in which it could be smoked, regardless of whether it contains tobacco. Electronic cigarettes that are not lit and operate by creating a vapour would not be covered by the legislation. More research is needed to understand whether there are any risks to health associated with secondhand vapour from e-cigarettes.

To gain a better understanding and inform future policy decisions on e-cigarettes, the Medicines and Healthcare products Regulatory Agency is co-ordinating a period of scientific and market research. The Department will use the information to consider how public health can be protected and promoted.

Meanwhile, we encourage smokers to use licensed nicotine replacement therapy such as patches, gum, inhalators, lozenges or mouth sprays, as the safest source of nicotine, in place of smoking.

Column 303W

Debate of the Queen’s Speech in the Lords

I will focus on tobacco control, which has been referred to by many noble Lords as a major omission from the gracious Speech. One in four cancer deaths are still thought to be due to smoking. Smoking kills one in two long-term smokers. These are shocking facts. I hope that whether noble Lords support standardised packaging or not, they will agree that it is deeply disturbing to learn that eight in 10 smokers start smoking by the age of 19.

Given this uptake of smoking by young people, we must surely all be united in taking whatever action we can to reduce or even stop the young people of this country from smoking. We must, therefore, consider the role of advertising and the role that promotion may play in drawing young people into smoking. Packaging is part of this.

It is no surprise, perhaps, that packaging is a vital issue to focus on, given the results of the 2012 study funded by Cancer Research UK, which included an audit of the tobacco retail press from January 2009 to June 2011. It found that, “the level of tobacco packaging activity is increasing. Brands appear to be in a continuous cycle of modernisation through pack redesign. Increasingly, innovative packaging and limited editions draw attention to the product”.

A review commissioned for the standardised packaging consultation concluded that there was, “strong evidence to support the propositions set out in the Framework Convention on Tobacco Control relating to the role of plain packaging in helping to reduce smoking rates; that is, that plain packaging would reduce the attractiveness and appeal of tobacco products, it would increase the noticeability and effectiveness of health warnings and messages, and it would reduce the use of design techniques that may mislead consumers about the harmfulness of tobacco products”.

Given this and our need to prevent millions of children from starting to smoke, we have a responsibility to introduce standardised tobacco packaging as part of a comprehensive strategy to tackle tobacco at local, national and international level.

Therefore, along with many of my colleagues across the health community, I am extremely disappointed that the Government did not include legislation in the gracious Speech. This absence of a Bill inevitably raises the question of the Government’s response to their consultation on standardised packaging. Nine months after the consultation ended, we are still awaiting a response from the Government. Can the Minister confirm that the Secretary of State for Health is still considering how the Government should respond to this consultation?

In the time we have been waiting, Cancer Research UK estimates that more than 150,000 children have started smoking. I call on the Government to respond in favour. We have waited long enough. We know that the Public Health Minister in the other place is convinced by the evidence, and there are many in this House who have voiced their concerns today, including the noble Lord, Lord Clement-Jones, the noble Baronesses, Lady Jolly and Lady Wheeler, my noble friend Lord Hunt, from the opposition Front Bench, and my noble friends Lord MacKenzie and Lord Patel, who have all voiced their concerns and hopes for government action.

Let us take a moment to reflect on the support for standard packs, which is extremely broad. I mentioned the support of the health community. I cannot overstate the extent to which health organisations agree with this measure. Smokefree Action Coalition brings together 190 health and welfare organisations: royal colleges, the British Medical Association, charities such as Cancer Research UK, the British Heart Foundation, the Trading Standards Institute and the Chartered Institute of Environmental Health. They all support the idea of standard packs.

This issue also resonates with the public. If one shows people examples of existing packs that are clearly aimed at young women, they are horrified. YouGov polling shows that 63% of adults support the removal of branding from cigarette packs, and just 16% are opposed. Some 85% of people back government action to reduce the number of young people who start smoking. In the Government’s consultation more than 200,000 members of the public supported standard packs. These are the supporters of standardised packaging: a majority of the public and more than 190 health and welfare organisations.

Yet their collective voice has at times struggled to be heard over the well organised campaign by the tobacco industry. In 2012, Japan Tobacco International said that it would spend £2 million on adverts arguing against standard packs. To date, the Advertising Standards Authority has ruled its claims to be “misleading” and “unsubstantiated”. While the tobacco industry argues that smuggling is increasing and that standard packs will make things worse, HMRC is clear that smuggling has halved in the past decade, and the Trading Standards Institute backs standard packaging, saying that pack design makes no difference to its efforts to tackle smuggling.

The evidence is clear and substantial. A majority of the public, 190 health organisations, the World Health Organisation and many others all support standard packs. The tobacco industry has spent millions on advertising to oppose standardised packaging, which indicates just how much store it sets by pack design.

Like the noble Baroness, Lady Jolly, I hope very much that when Her Majesty said in the gracious Speech that other measures will be laid before us, we will see a Bill aimed at stopping children taking up smoking through the introduction of standard cigarette packages.

Column 354

Industry Watch

South Africa: BAT rapped for unfounded advertising

There were also concerns that the design of the adverts, using brand elements that are associated with BAT products, contravened the Tobacco Products Control Act 1993 which makes it illegal to advertise or promote tobacco products.

[registration required]

Recent Research

Non-smoking hotel rooms fail to protect non-smokers

Methods A stratified random sample of hotels with (n=10) and without (n=30) complete smoking bans was examined. Surfaces and air were analysed for tobacco smoke pollutants (ie, nicotine and 3-ethynylpyridine, 3EP). Non-smoking confederates who stayed overnight in guestrooms provided urine and finger wipe samples to determine exposure to nicotine and the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone as measured by their metabolites cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), respectively.

Findings Compared with hotels with complete smoking bans, surface nicotine and air 3EP were elevated in non-smoking and smoking rooms of hotels that allowed smoking. Air nicotine levels in smoking rooms were significantly higher than those in non-smoking rooms of hotels with and without complete smoking bans. Hallway surfaces outside of smoking rooms also showed higher levels of nicotine than those outside of non-smoking rooms. Non-smoking confederates staying in hotels without complete smoking bans showed higher levels of finger nicotine and urine cotinine than those staying in hotels with complete smoking bans. Confederates showed significant elevations in urinary NNAL after staying in the 10 most polluted rooms.

Conclusions Partial smoking bans in hotels do not protect non-smoking guests from exposure to tobacco smoke and tobacco-specific carcinogens. Non-smokers are advised to stay in hotels with complete smoking bans. Existing policies exempting hotels from complete smoking bans are ineffective.

Matt, G., et al., Thirdhand smoke and exposure in California hotels: non-smoking rooms fail to protect non-smoking hotel guests from tobacco smoke exposure, Tob Control doi:10.1136/tobaccocontrol-2012-050824

Smoking and drinking by English school pupils

Method Data from 13,635 school pupils in the Longitudinal Study of Young People in England (LSYPE) on usage of cigarettes from 2004 (typical age 14) to 2006 (age 16) and alcohol from 2004 to 2007 (age 17), analyzed with latent growth curve models.

Results The weighted percentage of pupils drinking alcohol increased from 26% at age 14 to 71% by age 17, smoking from 12% to 27% by age 16. Pupils with lower socio-economic status were more likely to smoke but less likely to drink alcohol regularly. Both behaviors were positively correlated at age 14, adjusted for several confounding factors. The rate of increase over time was also positively correlated.

Conclusion Cigarette smoking and alcohol drinking are already correlated by age 14, are socio-economically patterned, and ‘move together’ during adolescence. Future studies and interventions should be targeted at a younger age range, to identify early smoking and potentially hazardous alcohol drinking patterns.

Hagger-Johnsona, G., et al., Cigarette smoking and alcohol drinking in a representative sample of English school pupils: Cross-sectional and longitudinal associations, Preventive Medicine, Volume 56, Issue 5, May 2013, Pages 304–308

Online smoking cessation help

Methods The intervention was cluster randomized trial at the dental practice level. Intervention dental practices were provided a longitudinal technology-assisted intervention, oralcancerprevention.org that included a series of interactive educational cases and motivational email cues to remind dental provides to complete guideline-concordant brief behavioral counseling at the point of care. In all dental practices, exit cards were given to the first 100 consecutive patients, in which tobacco users provided contact information for a six month follow-up telephone survey.

Results A total of 564 tobacco using dental patients completed a six month follow-up survey. Among intervention patients, 55% reported receiving advice to quit tobacco, and 39% of control practice patients reported receiving advice to quit tobacco (p < 0.01). Six-month tobacco use quit rates were not significantly between the Intervention (9%) and Control (13%) groups, (p = 0.088).

Conclusion Although we increased rates of cessation advice delivered in dental practices, this study shows no evidence that brief advice by dentist’s increases long-term abstinence in smokers.

Houston, T., et al.,Cluster-randomized trial of a web-assisted tobacco quality improvement intervention of subsequent patient tobacco product use: a National Dental PBRN study, BMC Oral Health 2013, 13:13 doi:10.1186/1472-6831-13-13

Rate of smoking cessation by age, gender and social grade

Design & Setting Cross-sectional surveys of population representative samples of smokers in England.

Participants 24,094 ever smokers (≥21 and ≤60 years of age) participating in household surveys between November 2006 and February 2011.

Measurements The ratio of long-term (>1 year) ex-smokers to ever-smokers was calculated for each age. Regression analyses were used to model the association between age and quit ratio, with the change in quit ratio by year of age n years versus all years up to n-1 years yielding an estimate of the quitting incidence at that age. Analyses were conducted for the entire sample and then for the sample stratified by gender and social grade, and interactions assessed between these variables.

Findings A cubic trend was needed to fit the data. The estimated long-term annual quitting incidence between ages 18 and 30 was 1.5% (95% CI=0.8%-2.2%), between 31 and 50 it was 0.3% (95% CI=0.0%-0.7%) and between 51 and 60 it was 1.2% (95% CI=0.0%-2.4%). Age interacted with gender and social grade: women and smokers from higher social grades had a higher incidence of quitting than men and those from lower social grades specifically in young adulthood.

Conclusions The incidence of smoking cessation in England appears to be greater in young and old adults compared with those in middle age. Women and higher social grade smokers show a greater incidence of quitting than men and those from lower social grades specifically in young adulthood.

Fidler, J., et al.,How does rate of smoking cessation vary by age, gender and social grade? Findings from a population survey in England, Addiction, DOI: 10.1111/add.12241

Impact of point-of-sale tobacco display bans

This study examined the impact of point-of-sale (POS) tobacco marketing restrictions in Australia and Canada, in relation to the United Kingdom and the United States where there were no such restrictions during the study period (2006–10). The data came from the International Tobacco Control Four Country Survey, a prospective multi-country cohort survey of adult smokers. In jurisdictions where POS display bans were implemented, smokers’ reported exposure to tobacco marketing declined markedly. From 2006 to 2010, in Canada, the percentages noticing POS tobacco displays declined from 74.1 to 6.1% [adjusted odds ratio (OR) = 0.26, P < 0.001]; and reported exposure to POS tobacco advertising decreased from 40.3 to 14.1% (adjusted OR = 0.61, P < 0.001). Similarly, in Australia, noticing of POS displays decreased from 73.9 to 42.9%. In contrast, exposure to POS marketing in the United States and United Kingdom remained high during this period. In parallel, there were declines in reported exposures to other forms of advertising/promotion in Canada and Australia, but again, not in the United States or United Kingdom. Impulse purchasing of cigarettes was lower in places that enacted POS display bans. These findings indicate that implementing POS tobacco display bans does result in lower exposure to tobacco marketing and less frequent impulse purchasing of cigarettes.

Li, L. et al., Impact of point-of-sale tobacco display bans: findings from the International Tobacco Control Four Country Survey, Health Educ. Res. (2013) doi: 10.1093/her/cyt058