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Smokers Undeterred as Bills Keep Rising

Since the beginning of the past fiscal year (ended in March) the taxes collected on tobacco products are paid to the Health Ministry (50%), Education Ministry (25%) and Ministry of Sports and Youth Affairs (25%) for anti-smoking campaigns

https://financialtribune.com/articles/people/65335/smokers-undeterred-as-bills-keep-rising

Iranians spend $1-1.5 million (40 to 50 billion rials) on tobacco products each day and the cost of treating tobacco-related disease is almost three times more than the amount spent on tobacco consumption.

During the past five years, the rate of tobacco consumption has only slightly decreased, studies conducted by the Health Ministry indicate. The rate is still high among adolescents and young people (the peak age for first trying of smoking has decreased from 13 to 10). The figure has also increased dramatically compared to the past decade, the Persian language weekly ‘Salamat’ reported.

“In 2006, Iranians smoked 50 billion cigarettes (worth $33.3 million). The figure reached 60-70 billion cigarettes in 2016,” said Dr Mohammadreza Madani, head of the Iranian Anti-Tobacco Association (IATA).

Another concern is the high prevalence of hookah (water pipe) for smoking flavored tobacco among young people. One hour of smoking hookah exposes a smoker 100-fold to the amount of smoke inhaled from a single cigarette. Even those people around a hookah smoker inhale smoke equal to 10 cigarettes.

Every year on May 31, the WHO marks World No Tobacco Day (WNTD), highlighting the health and additional risks associated with tobacco use, and advocating effective policies to reduce tobacco consumption.

The theme for World No Tobacco Day 2017 is ‘Tobacco – a threat to development.’

But irrespective of the programs to create awareness on the harmful effects of smoking, statistics show that 14-15% of Iranians from the 80 million population are regular cigarette smokers (more than 3% are women, and 20% men).

“Though most of the cigarette smokers are men, hookah smoking doesn’t vary by gender; 21.3% of women and 21.7% of men are hookah smokers,” Madani said.

Dodging Taxes

Iran is one of the nations that has signed the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), by which a country is committed to reduce the rate of tobacco consumption every year (by implementation of both price and tax measures as well as non-price measures to reduce demand for tobacco).

Pointing to Article 8 of the National Comprehensive Law on Tobacco Control, Madani said, “According to the law passed in 2006, every year taxes on cigarettes should be increased by 10%.”

“However, there have been always obstacles in its implementation. For example, in 2010 the figure decreased to 5% due to ‘manipulative tactics’ by the powerful tobacco lobby. Tobacco producers said that high taxes on cigarettes would lead to an increase in cigarette smuggling, and thus managed to reduce the tax.”

However, in January this year, lawmakers passed cigarette and tobacco tax slabs to be implemented under the sixth five-year economic development plan (2017-22).

Based on the new law, the tax slab on locally-produced tobacco and cigarettes is 10%; for local brands jointly produced by domestic and foreign manufacturers, it is 20%; for domestically produced cigarettes with foreign brand names the slab is 25%; and for imported cigarettes and tobacco, it is 40%.

Lawmakers also mandated the Ministry of Industries, Mining and Trade to announce the retail prices of cigarettes and all tobacco products to the relevant authorities for taxation purposes and for printing the tax rates on cigarette packs.

“Since the beginning of the past fiscal year (ended in March) the taxes collected on tobacco products are paid to the Health Ministry (50%), Education Ministry (25%) and Ministry of Sports and Youth Affairs (25%). The Education Ministry is required to spend the money on increasing students’ awareness of harms associated with tobacco smoking,” Madani said.

Earlier, the tax money was given to the ministries of health and sports and youth affairs.

Facts About Tobacco

There are more than 7 million deaths from tobacco use every year, a figure that is predicted to cross 8 million by 2030 without effective and intensified action. Tobacco consumption is a threat to any person, regardless of gender, age, race, cultural or educational background. It brings suffering, disease, and death, impoverishing families and national economies.

Tobacco use costs national economies enormously through increased healthcare costs and decreased productivity. Some 80% of premature deaths from tobacco occur in low- or middle-income countries, which face increased challenges to achieving their development goals, the WHO website reports.

Tobacco growing requires large amounts of pesticides and fertilizers, which can be toxic and pollute water supplies. Each year, tobacco growing uses 4.3 million hectares of land, resulting in global deforestation between 2% and 4%. Tobacco manufacturing also produces over 2 million tons of solid waste.

By increasing cigarette taxes worldwide by $1, an extra $190 billion could be raised for development. High tobacco taxes contribute to revenue generation for governments, reduce demand for tobacco, and offer an important revenue stream to finance development activities.

CIGARETTE FILTERS MAY INCREASE LUNG CANCER RISK

A study’s authors argue that tiny ventilation holes in virtually all cigarettes sold today are creating a new health risk.

http://ewn.co.za/2017/05/23/cigarette-filters-may-increase-lung-cancer-risk

Cigarette filters, introduced decades ago to reduce the amount of tar smokers inhale, also alter other properties of smoke and smoking in a way that raises the risk of lung cancer, researchers say.

In a review of research on changes in lung cancer rates, and changes in the types of lung cancer that are most common, the study authors argue that tiny ventilation holes in virtually all cigarettes sold today are creating a new health risk.

“The design of cigarette filters that have ventilation can make the cigarettes even more dangerous, because those holes can change how the tobacco burns, allow smokers to inhale more smoke and to think that the smoke is safer because it is smoother,” senior author Dr. Peter D. Shields from The Ohio State University’s Wexner Medical Center in Columbus told Reuters Health by email.

“This applies to all cigarettes, because almost all the cigarettes on the market have the holes, not just the ones that used to be called lights and ultra-lights,” he noted.

Although rates of lung cancer in the population have fallen with declines in smoking overall, rates of lung cancer among smokers have risen significantly, the researchers point out. And the type of lung cancer associated with smoking has also shifted since the 1950s.

Rates of adenocarcinoma of the lung, the lung cancer most associated with smoking, have more than quadrupled in men and increased eight-fold in women along with changes in the design and composition of cigarettes since the 1950s, the researchers write.

Shields and his team review the evidence linking cigarette filter ventilation to these increased rates of lung cancer in a report online 22 May in the Journal of the National Cancer Institute.

Filter ventilation reduces the amount of tar in the cigarette smoke when tested on smoking machines, but the increased ventilation and slower tobacco burn result in more puffs per cigarette and more toxic cancer-causing chemicals being inhaled by smokers, they write.

“The use of the ventilation holes yields lower tar only on a machine,” Shields said. “Machines have nothing to do with actual exposures in humans. The holes let them actually inhale more smoke with more cancer-causing agents.”

Because of the claims of lower tar content, though, smokers develop the false belief that a lower tar cigarette is a healthier cigarette, Shields’ team writes.

Increased filter ventilation also results in smaller particle size, allowing more smoke to reach vulnerable parts of the lung.

Moreover, even though machine-measured tar and nicotine levels have decreased over time, there has been no appreciable change in daily nicotine intake among smokers over the past 25 years, they write.

“The evidence shows that more modern cigarettes are more risky for lung cancer,” Shields said. “There are reasons in addition to the holes that also can contribute to the increasing risk, but one does not preclude the other.”

Cigarette designs could and should be regulated to address all the possible reasons, Shields said.

“The holes have no health benefits; they serve no health purpose,” he explained. “They do not lower tar delivery to people. So, if they have the potential harm, the FDA can act, even if the science is not perfect. The FDA can require cigarette manufacturers to make filters without the holes. This is easy and they are doing it for some brands already.”

Having filters may indeed be safer, Shields clarified. “This study is about the holes on the filters. We are not saying to remove filters, only to change their designs by removing the holes on the filters.”

“The FDA now has the authority to require the elimination of filter ventilation, as ventilation does not serve any public health purpose and instead provides a false promise of reduced risk,” the study team concludes.

“This single action for banning filter ventilation by the FDA is scientifically justified, and within its mandate to improve the public health,” they write.

There is some precedent for the ban Shields and colleagues propose, Jonathan M. Samet and Lilit Aladadyan, both from the Tobacco Center of Regulatory Science at the Keck School of Medicine of USC and the USC Institute for Global Health in Los Angeles, write in an accompanying editorial.

The evidence gathered by Shields’ team seems strong enough to support FDA action, and “given a lack of evidence for countervailing harms, ending filter ventilation could be a ‘no regrets’ action that would benefit public health,” they write.

Rise in Lung Adenocarcinoma Linked to ‘Light’ Cigarette Use

A new study shows that so-called “light” cigarettes have no health benefits to smokers and have likely contributed to the rise of a certain form of lung cancer that occurs deep in the lungs.

http://journals.lww.com/oncology-times/blog/onlinefirst/pages/post.aspx?PostID=1618

For this new study, researchers at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC–James) and five other universities/cancer centers examined why the most common type of lung cancer, called adenocarcinoma, has increased over the past 50 years, rather than decreasing as smokers have been able to quit. Other types of lung cancer have been decreasing in relationship to fewer people smoking, but not lung adenocarcinoma. Because of this, lung adenocarcinoma is now the most common type of lung cancer.

Results confirm what tobacco-control researchers have suspected for years: There is no health benefit to high-ventilation (light) cigarettes–long marketed by the tobacco industry as a “healthier” option–and these cigarettes have actually caused more harm. Holes in cigarette filters were introduced 50 years ago and were critical to claims for low-tar cigarettes.

“This was done to fool smokers and the public health community into thinking that they actually were safer,” said Peter Shields, MD, Deputy Director of the OSUCCC–James and a lung medical oncologist. “Our data suggests a clear relationship between the addition of ventilation holes to cigarettes and increasing rates of lung adenocarcinoma seen over the past 20 years. What is especially concerning is that these holes are still added to virtually all cigarettes that are smoked today.”

The FDA was given the authority to regulate the manufacture, distribution, and marketing of tobacco products through the Family Smoking Prevention and Tobacco Control Act in 2009. Current regulations ban tobacco companies from labeling and marketing cigarettes as “low tar” or “light.” Study authors, however, say that given this new data, the FDA should take immediate action to regulate the use of the ventilation holes, up to and including a complete ban of the holes.

“The FDA has a public health obligation to take immediate regulatory action to eliminate the use of ventilation holes on cigarettes,” added Shields. “It is a somewhat complicated process to enact such regulations, but there is more than enough data to start the process. We believe that such an action would drive down the use and toxicity of conventional cigarettes, and drive smokers to either quit or use less harmful products. There are some open questions about unintended consequences for enacting a ban, which provides for an important research agenda.”

A team made up of lung oncology, public health, and tobacco regulation researchers conducted a comprehensive, multi-faceted analysis of existing literature that included chemistry and toxicology studies, human clinical trials and epidemiological studies of both smoking behavior and cancer risk. They studied scientific publications in the peer-reviewed literature and internal tobacco company documents.

Researchers hypothesized that the higher incidence rates of lung adenocarcinoma were attributable to the filter ventilation holes, which allow smokers to inhale more smoke that also has higher levels of carcinogens, mutagens and other toxins.

“The filter ventilation holes change how the tobacco is burned, producing more carcinogens, which then also allows the smoke to reach the deeper parts of the lung where adenocarcinomas more frequently occur,” explained Shields.

To date, all the scientific evidence involves the adverse impact of adding ventilation, but not removing it. Additional research is needed to confirm that the addictiveness of the cigarette or toxic exposures from cigarettes would not increase with elimination of the ventilation holes. The OSUCCC–James and researchers at the University of Minnesota, Roswell Park Cancer Institute, Virginia Tech, Harvard University and Medical University of South Carolina are conducting additional research to reconcile human biomarkers studies and smoke distribution/exposure in the lung.

Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name

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World No Tobacco Day: Smoking robs your wallet, health – Cansa

On May 31 the world celebrates #WorldNoTobaccoDay.

Smoking-Infographic-2

Tobacco use is a threat to any person, regardless of gender, age, and race, cultural or educational background that causes over 18 types of cancer, and accounts for over 20 per cent of cancer deaths worldwide.

This is according to the Cancer Association of South Africa (Cansa) which advocates stopping the use of any and all tobacco products.

According to Cansa, tobacco can be found in many forms, and all tobacco use is harmful.

“People only think of cigarette smoking when you talk about tobacco, but it goes beyond that. They need to be aware that hubbly bubbly and e-cigarettes are just as harmful to your health and the health of those around you.

“It’s not just the smoker who has increased risk of disease, but also people exposed to second-hand smoke,” says Cansa health specialist, Prof Michael Herbst.

According to Dr Oleg Chestnov, World Health Organisation’s (WHO) Assistant Director-General for Non-communicable Diseases (NCDs) and Mental Health, on top of the health implications, tobacco products are getting more expensive and are creating a huge negative impact on the economy.

“The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries,” said Chestnov.

Herbst said: “There is so much more you can do with an average R30 a day, instead of buying a pack of cigarettes.

“Have you thought about that? Giving up smoking one pack a day, will free up close to R1000 a month, which can be used in better ways than harming your health, and the health of those around you. The financial impact is huge.”

He said hookah, or hubbly bubbly use is especially concerning among the youth.

“The tobacco is no less toxic in a hookah pipe and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do, because of the large volume of smoke they inhale in one smoking session.

“In South Africa, hubbly and their related tobacco products, fall under the definition of ‘tobacco product’ as indicated in the Tobacco Products Control Amendment Act (2007). This means that its use and sale have to comply with the regulations that apply to a tobacco product in the country.

“This includes the prohibition of the sale of hookahs and their products to anyone under the age of eighteen.

“Electronic cigarettes and similar devices are frequently marketed as aids to quit smoking, or as healthier alternatives to tobacco. This has not been proven, and e-cigarettes are not a better alternative to cigarettes.

“They still contain harmful chemicals, and it’s rather recommended to quit smoking by proven treatments. CANSA has a e-Kick Butt programme, which assists with quitting smoking (www.ekickbutt.org.za),” continued Herbst.

Cansa in a statement said it has played a significant role in contributing to tobacco control legislation in South Africa.

The organisation insist every one should be able to breathe tobacco-smoke-free air.

Offenses can be reported here: http://www.cansa.org.za/take-action-against-those-who-break-the-law/

According to Cansa:

Legislation is very clear about where people may smoke and where smoking is prohibited
It’s your right to complain when someone smokes in your presence
It’s also your right to take remedial steps if someone smokes in any area where smoking is prohibited
Adults may not smoke in a car when a passenger under 12 years is present
Smoking is not allowed in premises (including private homes) used for commercial childcare activities, such as crèches, or for schooling or tutoring
No person under 18 may be allowed into a designated smoking area
No smoking in partially enclosed public places such as balconies, covered patios, verandas, walkways, parking areas, etc.
The fine for the owner of a restaurant, pub, bar and workplace that breaks the smoking law is a maximum of R50 000 and for the individual smoker R500
The tobacco industry can no longer use ‘viral’ marketing like parties to target young people
The sale of tobacco products to and by persons under the age of 18 years is prohibited
Cigarette vending machines that sell tobacco products cannot be used to sell other products like crisps, chocolates etc.
For more info visit www.cansa.org.za or contact Cansa toll-free 0800226622 or at info@cansa.org.za as email address. Follow CANSA on Twitter: @CANSA (http://www.twitter.com/@CANSA) and join CANSA on Facebook: CANSAThe Cancer Association of South Africa and follow CANSA on Instagram: @cancerassociationofsouthafrica

The Hole Story: Ventilated Filters Make Smoking More Deadly

The ventilation systems built into cigarette filters in the mid-1960s to reduce tar and make smoking ‘smoother’ and ‘safer’ were responsible for the paradoxical rise in rates of lung adenocarcinoma — even as rates of other lung cancer subtypes dropped along with the number of smokers. These conclusions were in the 2014 US Surgeon General’s report on the health consequences of smoking.

http://www.medscape.com/viewarticle/880383

Now, two new weight-of-evidence reviews have pinpointed 25 “causation analysis evidence blocks” that could support an outright ban of filter ventilation, according to lead author, Peter G. Shields, MD, deputy director of the Comprehensive Cancer Center, the Ohio State University Wexner Medical Center, in Columbus, and colleagues.

The review found that between the 1960s and the 1980s, the health risks associated with smoking jumped almost 2-fold in men and increased 10-fold in female smokers. At the same time, the relative risks for adenocarcinomas rocketed from 4.6 to 19.0 in men and from 1.5 to 8.1 in women — even though the risks for other lung cancer subtypes didn’t increase. “Thus, there was a paradoxical increase for lung adenocarcinomas while squamous cell cancers decreased with decreased smoking rates,” the review authors write.

“The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers,” they say in a report published online May 22 in the Journal of the National Cancer Institute.

“Based on these weight-of-evidence reviews, the FDA [Food and Drug Administration] should embark on a regulatory process of data evaluation and consider regulation(s) for the use of ventilation in filters, up to and including a ban on their use,” the authors conclude.

“The prime point is to rally the troops to get the FDA to focus on this,” Dr Shields told Medscape Medical News. “To me, this is a policy paper. Physicians can’t be silent.”

This is a policy paper. Physicians can’t be silent. Peter D. Shields

Ventilation holes in filters are now found in nearly every brand of cigarettes, and they make smoking even more deadly, Dr Shields elaborated in an interview.

The tiny filter holes slow down tobacco combustion, giving smokers more puffs per cigarette but also allowing more toxic constituents to form, increasing the mutagenicity of the smoke, the review authors explain. To get the requisite nicotine hit from a cigarette with a ventilated filter, a smoker must also inhale more deeply, drawing smoke farther into the lungs and exposing cells vulnerable to adenocarcinoma.

Increasing amounts of tobacco-specific nitrosamines can also be found in new blended tobaccos that provide a “smoother” smoking experience, albeit with more carcinogens, Dr Shields commented. This makes smoking more dangerous than ever before, and patients need to know this, he emphasized.

“As part of your risk counseling, tell patients who smoke that the cigarettes today are more deadly than the cigarettes from 30 or 40 years ago. We need to take away smokers’ perception that any cigarette is safe. It’s like putting your head in a chimney,” Dr Shields said.

Increased Risk for Adenocarcinoma

In an accompanying editorial, Jonathan M. Samet, MD, and Lilit Aladadyan, MS, MPH, say that ending filter ventilation “could be a ‘no regrets’ action that would benefit public health.”

Dr Samet is professor and Flora L. Thornton Chair for the Department of Preventive Medicine at the Keck School of Medicine at the University of Southern California (USC) in Los Angeles, and Aladadyan is center director for the USC Tobacco Center of Regulatory Science.

The editorialists note the review looked at a “large and somewhat poorly circumscribed body of literature” and that the evidentiary threshold required for the FDA to take action is not supported by any record of precedents.

However, they also say that the review’s conclusion about the contribution of filter ventilation to rising rates of lung adenocarcinoma in smokers “is well justified” and supports “the indictment of filter ventilation as increasing risk for adenocarcinoma.”

Filter ventilation was originally designed to lower smoking machine tar yields in so-called light cigarettes marketed primarily to women as a “healthier” alternative to regular cigarettes. “This was done to fool smokers and the public health community into thinking that they actually were safer,” Dr Shields said in a statement.

In 2009, the Family Smoking Prevention and Tobacco Control Act gave the FDA authority to ban tobacco companies from labeling and marketing cigarettes as “low tar” or “light.”

Dr Shields has served as an expert in class action suits against tobacco companies marketing light cigarettes as a healthier alternative. He’s also heard lawyers for Big Tobacco say peer-reviewed evidence was needed. “From our perspective, there is more than enough data to start the process and it’s time for regulation,” he said. “We believe that such an action would drive down the use and toxicity of conventional cigarettes and drive smokers to either quit or use less harmful products. There are some open questions about unintended consequences for enacting a ban, which provides for an important research agenda.”

Future clinical trials could assess smokers switching to filtered cigarettes without ventilation, using a panel of biomarkers to measure exposure to carcinogens and lung toxicants, markers of oxidative damage and inflammation in lung, blood, or/and urine, the review authors suggest. At present, human exposure biomarker studies do not appear to support a causal relationship, they didn’t measure exposure in the lung or “utilize known biomarkers of harm,” they note.

Smokers’ perceptions, and transition to alternate products, should also be assessed, looking at differences by race and ethnicity, sex, age, and vulnerable populations. The effect of filter ventilation on the risk for other diseases, such as chronic obstructive pulmonary disease, could also be studied, they say.

This study was supported by the National Cancer Institute of the National Institutes of Health and the FDA Center for Tobacco Products. Dr Shields and coauthors Neal L. Benowitz, MD, and Theodore M. Brasky, PhD, disclose they have served as consultants and expert witnesses in litigation against tobacco companies. Coauthor K. Michael Cummings, PhD, MPH, declares a relationship with Pfizer Inc. The study authors and editorialists have disclosed no relevant financial relationships.

Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma

https://academic.oup.com/jnci/article-abstract/109/12/djx075/3836090/Cigarette-Filter-Ventilation-and-its-Relationship?redirectedFrom=fulltext

The 2014 Surgeon General’s Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from “lighter” smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.

Appeals Court Deals Blow To Tobacco Companies

More than a decade after the Florida Supreme Court opened the floodgates for lawsuits against tobacco companies, an Atlanta-based appeals court this week rejected arguments that could have helped shield cigarette makers in legal battles about smoking-related illnesses and deaths.

http://wlrn.org/post/appeals-court-deals-blow-tobacco-companies-0

The full 11th U.S. Circuit Court of Appeals ruled against R.J. Reynolds Tobacco Co. and Philip Morris USA, Inc., which contended that federal law trumps certain claims. The appeals court also rejected the companies’ arguments of due-process violations.

The case largely stems from a 2006 Florida Supreme Court ruling that established findings about a series of issues including the dangers of smoking and misrepresentation by cigarette makers. The ruling helped spawn thousands of lawsuits in state and federal courts, with plaintiffs able to use the findings against tobacco companies — lawsuits that have become known as “Engle progeny” cases.

The appeals-court decision Thursday came in an Engle progeny case tried in federal court in Jacksonville. The case was filed by the family of Faye Graham, who died after smoking for 41 years and developing chronic obstructive pulmonary disease and lung cancer, according to a brief in the case.

A jury ruled against R.J. Reynolds and Philip Morris on issues of strict liability and negligence. It also found Graham partially at fault, with a judge ultimately deciding that R.J. Reynolds should pay $550,000 in damages and Philip Morris should pay $275,000.

In the appeal, the tobacco companies argued, in part, that federal laws regulate cigarettes and, as a result, should prevent claims of strict liability and negligence based on the Engle findings — a legal concept known as federal preemption.

“The strict-liability and negligence claims in this case do not rest on any alleged defect specific to the cigarettes smoked by Mrs. Graham. Instead … they rest on the inherent riskiness of all cigarettes,” attorneys for the tobacco companies argued in a 2014 brief. “The claims here thus seek to enforce a legal duty, grounded in Florida tort law, to refrain from selling ordinary cigarettes. Because such a duty squarely conflicts with federal law, the claims here are preempted.”

But Thursday’s majority ruling, written by appeals-court Judge William Pryor, rejected such contentions, writing that “federal tobacco laws do not preempt state tort claims based on the dangerousness of all the cigarettes manufactured by the tobacco companies.”

“Florida may employ its police power to regulate cigarette sales and to impose tort liability on cigarette manufacturers,” Pryor wrote in the 43-page opinion.

The majority also rejected to the tobacco companies’ arguments that due-process rights had been violated in using the Engle findings in the Graham case.

But appeals-court Judge Gerald Tjoflat wrote an encyclopedic 226-page dissent on the preemption and due-process issues. As an example, in addressing the preemption issue, he wrote that judges “cannot give effect to the Florida Supreme Court’s decisions in a manner that operates as a ban on the sale of cigarettes without elevating state law over federal law.”

“I merely conclude that, having surveyed both federal and state law, it is clear that Congress would have intended to preempt Graham’s strict-liability and negligence claims, rooted as they are in a broadly applicable state law set forth by the Florida Supreme Court that deems all cigarettes defective, unreasonably dangerous, and negligently produced,” Tjoflat wrote.

What’s keeping Indonesia, China addicted to smoking?

A World Trade Organisation ruling backing Australia’s hard line on cigarette packaging highlights a gulf between Asia and much of the rest of the world

http://www.scmp.com/week-asia/society/article/2094162/whats-keeping-indonesia-china-addicted-smoking

It was during a trip to Egypt in 1995 when Edison Siahaan first felt that something wasn’t quite right with his throat. Four decades had gone by since he started smoking at the age of 15. His voice had been raspy for years. Maybe this was just the dry air tickling the back of his throat.

But it wasn’t dry air and it wasn’t a tickle. It was cancer. Doctors excised a portion of his trachea leaving a hole the size of a nickel at the base of the throat. He lost his bank job because for a year following the surgery he couldn’t speak. Even now, what passes for speech makes him sound like the emperor from Star Wars only with more hissing. Now 79, Siahaan, a kindly old gent with a full head of hair, is tough to look at. “I see kids smoking all the time here,” he says, gesturing back and forth along the length of the street from his front room. “It makes me sick to think they are going to ruin their life. I point at this hole in my throat and say to them: do you want to look like this?”

Asian men already account for the lion’s share of the world’s tobacco related illnesses, yet a World Trade Organisation ruling this week that upheld tough anti-smoking rules introduced in Australia in 2012, showed that if anything, the gap in attitudes between Asia and the rest of the world may be widening.

“Tobacco in China is absolutely devastating,” says Dr Angela Pratt who helps handle external relations at the World Health Organisation’s office for the Western Pacific in Manila.

In China, roughly 300 million people smoke, according to the WHO. Most of these are men. More than half of Chinese adults are smokers and two-thirds of young Chinese men start smoking. While smoking rates are steady, the absolute number of smokers is rising in line with population growth. Chinese smokers account for 44 per cent of all the cigarettes puffed in the world. At current rates 200 million Chinese will die this century from tobacco-related illnesses, Pratt says. “That’s a huge burden. The people afflicted are often the sole income earners,” she says.

This week, the WTO ruled that Australia’s plain packaging rules, which ban branding and distinctive colouring from packs of cigarettes, were a legitimate public health measure. The ruling knocked back a complaint from Indonesia, Cuba, Honduras and the Dominican Republic, who said the rule amounted to an illegal trade barrier. As the former chief of staff to the Australian health minister who introduced the plain packaging measures, Nicola Roxon, Pratt helped develop the policy, bulletproofing it from court challenges from tobacco companies and governments.

“We were proud to be taking on plain packaging,” Pratt recalls. “But we wanted to be sure to be able to defend it.”

Together with graphic warnings and taxes that will push cigarettes up to A$40 (HK$230) per pack by 2020, the measure is credited with accelerating the fall in Australia’s smoking rate. The most recent figures show about 13 per cent of Australian adults smoke and less than five per cent of school children. A dozen countries, from Canada to Chile and Britain to Uruguay are either introducing similar rules or seriously considering them.

At the other extreme is Indonesia. The most recent figures, which date back to 2013, show 240,000 Indonesians die every year from tobacco related illnesses. Two-thirds of Indonesian men and boys, over the age of 15, smoke, according to the Ministry of Health.

Most troubling are the numbers of new young smokers throughout the archipelago, says Dr Widyastuti Soerojo, chair of the tobacco control unit at the Indonesian Public Health Association. She says some 16 million Indonesian youngsters between the ages of 10 and 19 experiment with smoking every year – a rate of about 44,000 every day.

Indonesia is among the few countries that are not signatories to the United Nation’s Framework Convention on Tobacco Control, which among other things aims to curb the appeal of smoking for children.

Indonesia television and billboards feature handsome intrepid men jumping out of planes or into business meetings. Roadside kiosks individually sell clove cigarettes, known as kretek, for as little as 10 US cents each.

Governments in Jakarta and local governments in vote-rich provinces, such as Central Java and East Java, fend off calls for more curbs on smoking saying they provide badly needed jobs to rural families.

But mechanisation and growing taste for machine-made cancer sticks rather than hand-rolled types, belie that argument. Tobacco accounts for about half of one per cent of all jobs in Indonesia, according to the Southeast Asia Tobacco Control Alliance. Campaigners are quick to point out the country’s richest families have tobacco to thank.

The Hartonos, Indonesia’s richest family and worth US$17 billion, own kretek maker Djarum.

Indonesian cigarette sales totaled US$16 billion in 2015. Sampoerna, which is more than 90 per cent owned by Philip Morris, is Indonesia’s most valuable company.

“The government treats tobacco like it’s a normal industry but really this is neocolonialism by tobacco companies,” Dr Soerojo says.

In China, the culprit for health advocates is the China National Tobacco Corporation, which controls more than 98 per cent of the local market. Implementation of the UN tobacco convention falls to the Ministry of Industry, which is also home to the body that owns China Tobacco. “A parallel would be, back when I was with the health ministry, meetings were chaired by a representative of Philip Morris,” Pratt said. “There’s plenty of room for conflict of interest.”

Still, there’s progress. Beijing, Shanghai and Shenzhen, with a combined population of more than 60 million, have banned smoking in public areas. China hiked taxes on cigarettes in 2015. The move resulted in a 20 per cent jump in the retail prices of the cheapest brands. Owing to its massive market, that move alone resulted in a more than 2 per cent drop in world tobacco consumption in 2016.

In Indonesia, smoking is banned in most public spaces but enforcement peters out the further one travels from the centre of Jakarta. Indonesia introduced graphic warnings on packaging in 2012 and hiked excise taxes on cigarettes by 15 per cent in 2016. Even so, additional hikes for this year were scotched. Glimmers of light are on the horizon, says WHO’s Pratt, but plain packaging is still “a long way off”.

For Siahaan, his government’s halting go-slow approach is proof that cigarettes are insidious, and for him, more ruinous than narcotics. “At least with drugs you can get help,” he gasps. “For cigarettes, you see them everywhere.”

Smoking costs China $57 billion in 2014: WHO calls for national ban

The economic dividends from China’s tobacco industry are a false economy, which is at odds with government’s vision for China’s future, the World Health Organization (WHO) claimed on Friday.

http://www.ecns.cn/2017/04-16/253586.shtml

“The total economic cost of tobacco use in China in 2014 amounted to a staggering 350 billion yuan ($57 billion), a tenfold increase since 2000,” Bernhard Schwartlander, the WHO representative in China, told a press conference in Beijing.

The increase is a result of more people diagnosed with tobacco-related illness and increasing healthcare expenditure, according to a report jointly released by the WHO and the United Nations Development Program (UNDP) at the conference.

“The direct cost of treating tobacco-related diseases in China was about 53 billion yuan and the indirect cost was expected to be 297 billion yuan,” in which the productivity loss from premature deaths was a major concern, according to the report.

Meanwhile, the report said that tobacco represents an economy of the past as China’s tobacco companies do not fit the vision of an innovative, value-added future economy.

“Projected increases in these costs will lead to negative spillovers effects across many sectors, placing increasing challenges to Chinese economy and businesses, in addition to the social welfare and health system,” it said.

Wu Yiqun, deputy director of the Beijing-based Research Center for Health Development, a think tank, told the Global Times earlier that China has huge public support for a nationwide smoking ban, but the timetable to adopt a law has been on the back burner.

“The proposed law has been mainly stymied by tobacco industry officials due to the huge economic interests involved,” Wu said.

The sector handed over 1.1 trillion yuan ($170 billion) to the State in 2015, up 20.2 percent from the previous year, the State Tobacco Monopoly Administration said in 2016.

The revenue from the tobacco industry derives from corporations whose business model is to create dependence on a lethal substance.

China in 2016 adopted the “Healthy China 2030″ blueprint, which says China aims to reduce smoking rates among adults from 28 percent to 20 percent by 2030.

More than 1 million people die of tobacco-related diseases every year in China, and the number is expected to reach 3 million by 2050 if no action to reduce smoking rates is taken. About 44 percent of the world’s cigarettes were consumed in China in 2014, nearly 26 percent higher than that in India, the report said.

China’s Ministry of Finance announced in May 2015 to raise cigarette taxation from the previous 5 percent to 11 percent, which “led to a reduction in cigarette sales for the first time in 20 years,” according to the report.

However, “cigarettes are increasingly affordable as the increase in cigarette prices has been much lower than the average increase in salaries.”