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WHO China launches smoke-free campaign targeting youth

The World Health Organization (WHO) started a “smoke-free generation” media campaign in Beijing Thursday targeting young Chinese.

http://www.china.org.cn/china/2017-06/03/content_40957899.htm

China is in the grip of a national tobacco epidemic, and children are most susceptible with cigarettes portrayed as fashionable and alluring in popular culture, said Bernhard Schwartlander, WHO Representative in China at the launch event.

According to WHO, over half of Chinese adult men smoke, two thirds of whom started as young adults. By 2014, 72.9 percent Chinese students had been exposed to secondhand smoke.

“There is nothing cool about smoking, but there is something empowering about choosing to live a healthy, smoke-free life,” said Schwartlander.

Since China ratified the WHO Framework Convention on Tobacco Control in 2005, the country has made a number of tobacco control efforts, including banning tobacco advertisements, increasing tobacco taxes and putting forward regional smoking bans.

As of 2016, 18 cities, including Beijing, Shanghai and Shenzhen, had implemented regional smoking bans.

China has set a target to reduce the smoking rate among people aged 15 and older to 20 percent by 2030 from the current 27.7 percent, according to the “Healthy China 2030″ blueprint issued by the central authorities last October.

Cheaper cigarettes, roll-your-own tobacco slows smoking’s downward spiral

Yesterday morning, Australia’s tobacco industry woke to the latest chapter in the book documenting its inexorable decline.

https://theconversation.com/cheaper-cigarettes-roll-your-own-tobacco-slows-smokings-downward-spiral-78745

The Australian Institute of Health and Welfare released data from its 2016 National Drug Strategy Household Survey, which it has conducted every three years since 1985.

While it was always going to be hard to show even further decline in teenage smoking from what was an already very low level, it’s happened again.

The proportion of teenagers (aged 12-17) who have never smoked more than 100 cigarettes significantly increased between 2013 and 2016, from 95% to 98%. Smoking more than 100 cigarettes in a lifetime has long been used in Australia as a benchmark question to sort curious, experimental smokers from more committed and addicted smokers.

Younger people also continued to delay when they first smoked their first full cigarette. This increased in the 14 to 24-year-olds from 14.2 years in 1995 to 16.3 in 2016 (a statistically significant increase from 15.9 years in 2013).

Catch ‘em young

The tobacco industry knows it needs to attract and addict new consumers to replace those who stop smoking through quitting and death. As a 1981 report sent to the then vice-president of research and development at Philip Morris put it:

Younger adult smokers are the only source of replacement smokers … If younger adults turn away from smoking, the industry must decline, just as a population which does not give birth will eventually dwindle.

Australia’s plain packaging legislation, implemented in December 2012, was aimed at reducing teenage Australians taking up smoking. As the health minister who introduced it, Nicola Roxon emphasised in April 2010 when announcing the policy:

We’re targeting people who have not yet started, and that’s the key to this plain packaging announcement – to make sure we make it less attractive for people to experiment with tobacco in the first place.

As Australian young people have turned away from smoking, the tobacco industry is left scrambling for new ways to addict young customers to nicotine.

Total smoking levels remain level

The proportion of people of all ages who smoke was also not good news for the tobacco industry.

The percentage of people aged 14 and over who smoke daily is down from 12.8% in 2013 to 12.2% in 2016. While any decline is welcome, this was less than it should have been, and the first time in two decades that a statistically significant fall was not recorded.

There are several factors likely to be responsible for the previously brake-less downward slide in smoking.

Long-time campaigners Mike Daube and Todd Harper have set out nine strategies the Australian tobacco industry has used so it can keep earning from the deaths of two in three Australian smokers likely to die from using their products.

Two critical factors here are price discounting and the dramatic rise of roll-your-own tobacco.

How price discounting works

Plain packaging means brand differentiation is gone as all packs look the same, except for the written brand name. So, the ability of branding to convince gullible smokers that premium (expensive) brands are somehow “better” and worth spending more on than cheaper, budget brands goes out the window.

After plain packaging was introduced, there was an industry-wide decision to cut prices to compete with lower priced brands for market share. There were large tobacco tax rises in the run-up to plain packs being introduced (25% in 2010) and a further 12.5% each year from 2013 to 2016.

Again, the tobacco companies cut their margins by desperately trying to keep some brands below A$20 a pack, a price known to trigger quitting.

These practices may see renewed interest in floor pricing of tobacco products, when a price is set below which a product cannot be sold.

Rise in roll-your-own tobacco

Tobacco companies have also aggressively pushed cheaper roll-your-own tobacco by introducing loose tobacco with cigarette brand names. The tax in roll-your-own tobacco will rise from September 2017, which may see a further round of price discounting to try and stop people quitting.

The use of roll-your-own cigarettes has gone from 26% of smokers in 2007, to 33% in 2013 and to 36% in 2016. Lower price is one factor driving this, but so too are the quite erroneous beliefs that roll-your-own tobacco somehow contains fewer additives and is less harmful, an issue I will explore in my next column.

The increase in roll-your-own cigarettes since 2007 has been largest among smokers aged under 40 (increase of 82% for young adults and 70% for smokers in their 30s between 2007 and 2016). Between 2013 and 2016 roll-your-own use in smokers in their 30s jumped from 29% to 37%.

National campaign wheels fallen off

Sustained and adequately funded mass media campaigns are a vital component of strategies health authorities recommended to change health behaviours, like smoking.

And with smoking, one of the most obvious pieces of evidence comes from ex-smokers about why they stopped smoking. There are light-years between the answer that has always been given (concern about health) and everything else (cost, social unacceptability, pregnancy etc).

In this study of smokers in 20 US communities, 91.6% of ex-smokers nominated “concern for your own current or future health” as why they quit compared with 46.5% who nominated “pressure from family, friends or co-workers”.

Without large scale, on-going campaigns that reach large proportions of the population with unforgettable, motivating information about why smoking is so harmful, the core driver of quitting and not starting smoking may wane.

Regrettably, Australia’s world famous national tobacco campaign that started in 1997 and has been used by many other countries, has been mothballed since 2013 when the Coalition government took office.

Smokers still get sporadic small bursts of quit smoking ads on television in some states from state health departments. But they are not getting a fraction of the highly motivating exposures that were a big part of our earlier rapid declines. This absence is almost certainly a major factor explaining the slow down in people quitting smoking.

E-cigarettes

The latest stats show that while around 31% of smokers (ie 3.8% of the 14+ population) had ever tried e-cigarettes, 20% seemed to have done so out of curiosity (once or twice) with only 4.4% currently using them (the remaining 6.8% no longer use them). Just 1.5% of smokers were using e-cigarettes daily (0.8% of ex-smokers and 0.2% of never smokers).

There’s no evidence from these very small numbers that e-cigarette use is contributing to falling smoking in Australia.

Many are concerned that the tobacco industry (which has bought into vapourisers big time) has a business plan to have smokers vape and smoke, not vape instead of smoking. If that plays out, increases in vaping may in fact act to further slow people from quitting smoking. The next few years will provide important information on this important issue.

High cigarette prices can really make you quit smoking

WHO says increased taxation on tobacco is least expensive and most effective tool in reducing smoking worldwide.

http://www.aljazeera.com/indepth/interactive/2017/05/high-cigarette-prices-quit-smoking-170525092939544.html

Tobacco remains one of the major risk factors for a number of chronic diseases, including cancer, lung and cardiovascular diseases. The World Health Organization (WHO) estimates that tobacco is responsible for the death of around seven million people across the globe every year.

Over the last two decades, there has been a significant reduction in the percentage of people smoking every day across the world, but the WHO says a lot more needs to be done to deter people from smoking cigarettes.

In a bid to curb consumption, governments have been enforcing stricter regulations on tobacco products and their usage.

Several countries are increasingly implementing strategies to tighten their tobacco policies in the hopes of deterring smoking, especially among young people.

Raising taxes on tobacco products is seen to be one of the least expensive and the most effective tools in countering the influence of tobacco companies. But it is also the least implemented, with only 10 percent of the world’s population currently living in countries with sufficiently high taxes.

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A 2010 WHO report found that 78 percent of those aged 15 years and over in the WHO member states were non-smokers.

By 2025, the number of non-smokers is expected to rise to around 5 billion out of a projected 6.1 billion people aged 15 and over.

Currently, nearly a third of all men are smokers, making the prevalence of smoking among men considerably higher than among women. Over the past 30 years, smoking among men has decreased by 10 percent.

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The price of a pack of cigarettes

Increasing prices and adding tax measures on tobacco products has been used to decrease the demand for cigarettes.

Many countries have successfully used tax policies to regulate the price of cigarette products. In Australia, a pack of cigarettes can cost up to $18, making it the most expensive country to buy cigarettes.

A report by the Australian Institute of Health and Welfare (AIHW) in 2016 found that the smoking rate in the country was at an all time low. In the last 20 years, smoking had decreased by almost 50 percent.

The study showed that less than 13 percent of Australians are daily smokers and fewer people are starting to smoke.

The report cites Australia as having one of the lowest smoking rates in the world, in part because of their implementation of increased taxes on tobacco products, plain packaging, and more restrictive smoke-free environment laws.

prices-cigs

Illicit trade in tobacco products

The tobacco industry and other interest groups argue that increased taxes on tobacco products allows an illicit black market trade in tobacco to thrive.

But the WHO says that high-income countries with taxes on tobacco products do not face widespread issues related to illicit trade, while low-income countries continue to do so, precisely because of weaker tobacco-control programmes and taxes. Nearly 80% of the world’s smokers live in low to middle-income countries.

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Mumbai: Over 40 NGOs, Tata Hospital join hands against tobacco

Mumbai: To mark ‘World No Tobacco Day’ which falls on May 31, more than 40 Non-Governmental Organisations, (NGOs) in collaboration with the Tata Memorial Hospital, Parel have formed a coalition to reduce the consumption of tobacco in India.

http://www.freepressjournal.in/mumbai/mumbai-over-40-ngos-tata-hospital-join-hands-against-tobacco/1077580

Dr. Pankaj Chaturvedi, professor and surgeon of Tata hospital, said that every third person in India consumes tobacco in different forms. He stated that the theme, ‘Tobacco- a threat to development’ specifically highlights the link between the use of tobacco products, tobacco control and sustainable development.

Dr. Chaturvedi further said that 33 per cent of tobacco users die a premature death due to cancer, heart attack, lung diseases, stroke etc. A smoker loses 8 years of his life due to this addiction.

“Tobacco is responsible for nearly 50 per cent cancers in India and 90 per cent of mouth cancers. Half of the mouth cancer patients die within 12 months of diagnosis,” said Dr. Chaturvedi.

Dr. Vijay Satbir Singh, additional chief secretary Public Health Department said that the main aim is to regulate the consumption of tobacco by implementing the Cigarettes and Other Tobacco Products Act (COTPA Act).

“The main challenge is to enforce traders to implement the warning signs and stop selling loose cigarettes. Stern action will be taken against those who are not following the law,” said Dr. Singh.

What is COTPA Act?

The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 was enacted in 2003 to prohibit advertisement of tobacco products and to regulate them in India.
The Act prohibits smoking of tobacco in public places, except in special smoking zones in hotels, restaurants and airports and open spaces.
Advertisement of tobacco products including cigarettes is prohibited.
Tobacco products cannot be sold to person below the age of 18 years, and in places within 100 metres radius from the outer boundary of an institution of education.
Tobacco products must be sold, supplied or distributed in a package which shall contain an appropriate pictorial warning, its nicotine and tar contents.

Where smoking is the leading cause of death and ill health

Rich countries are hit the hardest but poor ones may soon follow

http://www.economist.com/blogs/graphicdetail/2017/05/daily-chart-22

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TODAY is World No Tobacco Day. Although in most countries the proportion of people who smoke continues to fall, campaigners see the glass as half full. In 24 countries smoking causes the largest share of the overall burden of disease, measured in years lost to ill health and premature death. In another 37 countries it ranks second. Most of these 61 countries are rich. Although their smoking rates are falling, much of the decline is because fewer young people are picking up the habit, rather than because older smokers are quitting. The harms from smoking affect people most seriously after middle age, so countries where smoking became popular a generation or more ago are worst affected—for now.

In poor countries, smoking is still a less important cause of death and disability than several other things, such as dirty water and malnutrition. Few African and Asian women light up—smoking is often socially acceptable only for men. In many of the poorest countries, smoking is still uncommon—though in some it is on the rise. As developing countries grow less poor, other harms will dwindle and smoking will start to look deadlier by comparison.

World No Tobacco Day: Poor almost three times more likely to smoke

360,000 NI residents still estimated to smoke, with men more likely to light up

http://www.belfastlive.co.uk/news/health/world-no-tobacco-day-poor-13117577

People in the most deprived areas of Northern Ireland are almost three times more likely to smoke than their better off counterparts according to the Public Health Authority NI.

Considered by the World Health Organisation to be a blight on health, the environment and household income, the international health organisation also revealed today – on World No Tobacco Day – that globally, there are 226million adult tobacco users living in poverty.

And in low income countries over 10% of a smoker’s budget can be spent on tobacco products, meaning less money for food, education and health care.

“Tobacco use hits the poorest people the hardest and exacerbates poverty,” said Dr Margaret Chan, Director General of WHO.

“Spending on tobacco products often represents more than 10% of total household income.

“(It) is a deadly product that kills more than 7million people every year, and costs the global economy more than $1.4trillion annually in healthcare expenditure and lost productivity.”

“In addition to posing a serious threat to health,” she added, “tobacco use also threatens development in every country on every level and across many sectors – economic growth, health, education, poverty and the environment – with women and children bearing the brunt of the consequences.”

Closer to home, the Public Health Authority said it is currently estimated that around 320,000 people aged 16 and over smoke in Northern Ireland, with men (23%) slightly more likely to light up than women (21%).

But, in line with global trends, they said there is also a strong link between smoking prevalence and deprivation here, while those in manual occupations are three times more likely to smoke than professionals.

The 2015/16 Health Survey NI found that 36% of respondents in the most deprived areas used tobacco, but this figure is just 13% among the more well off.

And while the number of smokers is falling, with 80% of those who still do forgoing the addiction in their homes and cars, there is still more work to be done.

“Protecting people from tobacco smoke is a key objective set out in the Ten Year Tobacco Strategy for Northern Ireland,” said Colette Rogers, Head of Health and Social Wellbeing Improvement from the Public Health Agency.

“Therefore, the Public Health Agency would welcome a ban on smoking in cars as a means of protecting young people from exposure to second-hand smoke, improving people’s health and helping to reduce the uptake of smoking in Northern Ireland.

“Smoking remains the single greatest cause of preventable illness and premature death in Northern Ireland so we urge smokers to quit by seeking the help of their local stop smoking service.

“In Northern Ireland there are more than 650 free PHA-funded stop smoking services which are run by specially-trained staff who can advise on the best way to stop smoking.

“Services are offered in many community pharmacies, GP practices, HSC Trust premises, and community and voluntary organisations, and can be set up in workplaces.”

Stop Smoking: It’s Deadly and Bad for the Economy

Higher taxes on tobacco products reduce tobacco consumption and improve public health, while also increasing government revenues that can be used to fund priority investments and programs that benefit the entire population.

http://www.worldbank.org/en/news/infographic/2017/05/31/stop-smoking-its-deadly-and-bad-for-the-economy

WBG_NoTobaccoDay_Infographic_052417-Final

Big investors warn against tobacco investment on World No Tobacco Day, but smoking in Europe is still stubbornly high

Today marks the passing of the 30th World No Tobacco Day, designed to encourage smokers to abstain for a day in the hope that they might quit.

http://www.cityam.com/265672/big-investors-warn-against-tobacco-investment-world-no

Yet it seems the annual event is doing little to help people kick the habit, despite support from big investors such as Axa and Calpers who are using the day to encourage a reduction in tobacco investment.

According to a survey of EU citizens, published by the European Commission to coincide with World No Tobacco Day, there has been no decrease in the number of daily smokers since 2014 – and even an increase among 15- to 24-year-olds.

“The increase in youth smoking rates illustrates the urgency for member states to enforce the provisions of the Tobacco Products Directive, which forbid attractive cigarettes aimed at enticing young people,” said EU commissioner for health and food safety Vytenis Andriukaitis.

The directive, which came into force in May this year, forbids tobacco manufacturers from marketing products as flavoured and requires them to cover 65 per cent of the packaging in health warnings.

Yet the overall smoking rate in the EU has remained at 26 per cent since 2014 and has risen from 25 per cent to 29 per cent in people aged 15 to 24.

Smoking in the UK sits fairly well below the European average, with 17 per cent of the population taking a daily puff.

Greece, Bulgaria, France and Croatia all rank highly, with smoking rates in each country above 35 per cent. Yet in Sweden, only seven per cent of people will regularly smoke a tobacco product.

Axa, Calpers, Scor and AMP Capital are putting their weight behind the push to quit, sponsoring the world’s first global investor statement on the subject.

It aims to “make visible the strong support within the financial community” for the World Health Organisation’s (WHO) framework on tobacco control and encourage stakeholders to act against tobacco investment, Axa said.

Axa and AMP Capital divested from tobacco last year, while Calpers did so 17 years ago and has since widened its ban to include externally managed funds.

The substance kills more than seven million people each year according to WHO, which has coordinated World Tobacco Day since the first event in 1988, and costs households and taxpayers more than $1.4trn (£1.1trn) in healthcare expenditure and lost productivity.

Hooked on tobacco

Majority of young Malaysians are well aware of the health hazards of smoking, but few would actually take them seriously.

http://www.mysinchew.com/node/117728

A survey conducted by National Cancer Society Malaysia (NCSM) on 143 students aged between 13 and 17 from four schools finds that 85% of students know that tobacco could lead to lung cancer while 95% know smoking is harmful to health.

However, 70% of students say they started smoking when they were 12 to 15 years old.

NCSM president Dr Saunthari Somasundaram told Sin Chew Daily they had organized the campaign to help school students quit smoking.

“From there we can learn more about these youngsters’ knowledge, attitude and behavior towards smoking. Alarmingly they are well aware of the various health hazards in relation to smoking, but they do not have the right ‘opportunity’ to quit.

“We will provide counseling services three months before the event. If they have stopped smoking during the past three months, this shows they have successfully quit smoking.”

Unfortunately, she said, many parents did not support their children to join the event for fear their smoker identity would be exposed.

According to The Tobacco Atlas published by the American Cancer Society in 2013, 19% of Malaysian teenagers smoked every day, including 17.1% of men and 1.9% of women.

May 31 is World No Tobacco Day. The theme for this year is: Tobacco, a threat to development.

World No Tobacco Day: Effects of shisha or hookah on the heart

Did you know 163.7 million in India consume these smokeless variants and are prone to cardiac ailments?

http://www.thehealthsite.com/news/world-no-tobacco-day-effects-of-shisha-or-hookah-on-the-heart-b0517/

According to statistics, about 6 million people in India die every year due to tobacco consumption and approximately 163.7 million users consume only the smokeless variants like sheesha (shisha or hookah). But still, the number of people dying due to tobacco consumption every year is higher than that due to tuberculosis, HIV-AIDS, and malaria put together. Be it tobacco smoking or use of smokeless tobacco like hookah, every form of tobacco contains more than 30 cancer-causing substances along with nicotine which can cause irreparable damage to the body.

Effects of Shisha on the heart

Dr Manoj Kumar, Associate Director & Head, Cardiac Cath Lab, Max Super Specialty Hospital, Patparganj, New Delhi, says, ‘Smokeless tobacco and sheesha affect the heart in multiple ways. Inhalation of the high levels of carbon monoxide reduces the oxygen-carrying capacity of the blood, leading to an overall drop of oxygen circulating in the body. This causes a drastic increase in the heart rate and blood pressure leading to a lot of exertion on the cardiovascular system. People addicted to such forms of tobacco are more prone to cardiac arrest, high blood pressure, stroke, haemorrhage, blood clot and other heart-related ailments. People with a risk of cardiac ailments or a history of cardiac arrest have twice the risk of mortality if they continue the usage of snuff or other smokeless tobacco products even after an attack.” Here are more side effects of hookah.

Is a sheesha bad for you?

There is no safe form of tobacco. Smokeless tobacco and sheesha, two other variants of tobacco, are equally harmful to heart health. Those forms of tobacco which are not burnt are termed as smokeless. Sheesha, on the other hand, is a form of fruit-flavored tobacco which is roasted in a foil along with charcoal and passed into a small chamber of water through a glass-bottomed pipe, which is then inhaled slowly. The WHO points that the total volume of smoke and carcinogens inhaled during an hour-long session of sheesha is equivalent to smoking 100 to 150 cigarettes with an average sheesha user inhaling approximately one-sixth of a litre of smoke in just one inhale.

Dr Santosh Kumar Agarwal, Senior Interventional Cardiologist, Kailash Hospital and Heart Institute, Noida, says “All forms of tobacco are dangerous to smokers and non-smokers alike. The nicotine in tobacco is what makes people addicted to it. Whether it is smoking or chewing, tobacco damages blood vessels, temporarily raises blood pressure and lowers exercise tolerance. It also reduces the oxygen-carrying capacity of blood and increases the tendency for blood to clot. Blood clots in the arteries can further cause a range of heart problems, which ultimately result in a stroke or sudden death.’ Read more on hookah or cigarettes, which is more harmful?

How to quit smoking hookah?

Here are some tips to try and quit this deadly habit.

1. Try short-acting nicotine replacement therapies such as nicotine gum, lozenges, nasal sprays, or inhalers. These can help you overcome intense cravings.

2. Identify the trigger situation, which makes you smoke. Have a plan in place to avoid these or get through them alternatively.

3. Chew on sugarless gum or hard candy, or munch raw carrots, celery, nuts or sunflower seeds instead of tobacco.

4. Get physically active. Short bursts of physical activity such as running up and down the stairs a few times can make a tobacco craving go away. Also read about 7 simple ways to control the urge of ‘just one puff’!

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