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Kentucky leads nation in adult smoking

Once again, Kentucky ranks first for its adult smoking rates, barely inching ahead of West Virginia to take back the first place spot, according to the federal Centers for Disease Control and Prevention.

http://www.richmondregister.com/news/kentucky-leads-nation-in-adult-smoking/article_6f814c88-c8a2-11e6-aa59-4320ad1ca961.html

Kentucky’s adult smoking rate in 2015, the latest period available, is 25.9 percent; West Virginia, which ranks second, is at 25.7 percent. That means that more than one-fourth of the adults in both of these states smoke. Arkansas closely follows at 24.9 percent.

States with the lowest smoking rates are Utah at 9.1 percent and California at 11.7 percent.

“Tobacco use is the leading cause of preventable disease and death in the U.S., accounting for more than 480,000 deaths every year, or one of every five deaths,” says the CDC.

Nationwide, smoking rates have declined almost 28 percent since 2005, to 15.1 percent in 2015 from 20.9 percent in 2005, says the CDC report based on the 2015 National Health Interview Survey. Kentucky’s smoking rates declined 10 percent in the same time frame, from 28.7 percent to 25.9 percent respectively, according to the Behavioral Risk Factor Surveillance System, a constant national poll conducted by the CDC.

The report also notes that smoking is more prevalent among men, Native Americans, the poor, the less educated, Midwesterners and Southerners, people who on are Medicaid or are uninsured, and those who have a disability, are gay or bisexual, or have mental-health issues.

The CDC says we know how to reduce smoking: “Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns and barrier-free access to tobacco cessation counseling and medications, are critical to reducing cigarette smoking and smoking related disease and death among U.S. adults; particularly among subpopulations with the highest smoking prevalence,” said the report.

Kentucky has room for improvement in all of these areas.

Kentucky ranks in the bottom 10 states (43rd) for its cigarette tax, at 60 cents per pack, and spends only 4.4 percent of what the CDC recommends for smoking cessation efforts ($2.5 million a year). The state’s high smoking rate also comes with a hefty price tag, as the Campaign for Tobacco-Free Kids estimates Kentucky smoking-related health costs at $1.92 billion a year. The group ranks Kentucky 37th in protecting children from tobacco, and says 17 percent of its high-school students smoke.

And though Kentucky has tried to pass one in the past, Kentucky does not have a comprehensive statewide smoke-free law and isn’t likely to get one any time soon because Republican Gov. Matt Bevin does not support such a law, saying this should be a local decision. State Health Commissioner Hiram Polk said in October that he’s looking for away to get Bevin to alter his policy: “We’ve got to find some kind of landmark we can use there that would be acceptable to the governor and get through the legislature.”

About one-third of Kentuckians are protected by local comprehensive smoke-free workplace laws, according to the Kentucky Center for Smoke-free Policy.

In contrast, Utah, which has the lowest smoking rate (9.1 percent), does have a comprehensive statewide smoke-free law, has a cigarette tax of $1.70 per pack and spends $7.1 million on tobacco cessation initiatives, which is almost 37 percent of the CDC’s recommended spending. And Utah spends less on health cost caused by smoking at $542 million.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Hong Kong leads mainland in war to cut smoking

http://www.ejinsight.com/20161209-hong-kong-leads-mainland-in-war-to-cut-smoking/

When a person goes to buy a packet of cigarettes in Hong Kong, he or she faces two obstacles. One is the price — Double Happiness at HK$43 and Marlboro at HK$57 — the result of a tobacco tax up to 68 per cent of the price.

The other is the hideous image on the packet of the worst consequences of smoking.

A survey by the Economic Intelligence Unit earlier this year ranked Hong Kong as the eighth most expensive city in the world for a packet of branded cigarettes, at US$7.48.

Top was London with US$14.30, followed by New York with US$13.67 and Singapore with US$9.15.

These two measures, along with the creation of smoke-free areas in public and work places, have been effective in cutting the number of smokers.

According to government figures, the percentage of daily cigarette smokers aged 15 and above in Hong Kong in 2015 was 10.5 percent, down from 10.7 percent in 2012 and 23.3 per cent in the early 1980s.

The mainland, the world’s largest tobacco market with 316 million smokers in 2015, has only recently started to learn the lessons of Hong Kong.

Since 2010, the number of smokers has increased by 15 million and cigarette production risen by 35 per cent.

The health warnings are written, not visual, and appear modestly at the bottom of the packet. They would not frighten any first-time user.

In 2015, China increased the tobacco tax to 40 per cent. Consumption tax from tobacco in 2015 was 536 billion yuan, an increase of 60 billion from a year earlier. The recommendation of the World Health Organisation (WHO) is that the tax should be 70 per cent of the retail price.

“There is certainly room for future tobacco tax increase,” said Jian Shi, director of the information office of the Taxation Research Institute at the State Administration of Taxation in Beijing.

“In some western countries, the tobacco tax rate has reached 70-80 per cent. The room for the increase needs to be considered based on the development goal of the industry and the condition of national revenue.”

Health professionals argue that increasing the tobacco tax is the quickest and most effective way to cut smoking — by both preventing young people from starting and encouraging smokers to quit.

According to WHO figures, each increase of 10 per cent in the price will cause 3.7 per cent of adults and 9.3 per cent of teenagers to stop smoking.

Antonio Kwong Cho-shing, chairman of the Hong Kong Council on Smoking and Public Health, said that selective or modest hikes would not make much of an impression on smoker numbers in Hong Kong.

“Only a 100 per cent increase in tobacco tax would induce people to quit smoking,” he said. If the government accepted this proposal, an average pack would cost HK$119.

The Department of Health has proposed an enlargement of the health warning.

It said on Nov. 23 that the area of the graphic health warning shall be of a size that covers at least 85 percent of the two largest surfaces of the packet or the retail container and that the number of forms of health warning should be increased from six to 12.

The situation in the mainland is years behind. The biggest obstacle is that the State Tobacco Monopoly Administration (STMA), the world’s biggest manufacturer of cigarettes, is also the industry regulator.

This is despite years of lobbying by China’s health professionals, the WHO and the norms practised around the world. They argue that the two must be separate institutions.

According to WHO figures, 1.2 million die each year in China from smoking-related diseases; this number will double by 2025.

Jian Shi put it succinctly. “The major difficulty lies in that the related departments have quite different views on this matter, and it is difficult for them to reach agreement on this matter. That will cause obstruction to policy making and implementation.”

The STMA opposes graphic health warnings and higher taxes because they would hurt its sales and profits. Yet, simply due to global population expansion, there will be more smokers in 2040 than there are today, so it is difficult to believe that this concern is genuine.

The health lobby has had some success, in the modest increase in tobacco tax and restrictions on smoking in indoor public areas and workplaces and some outdoor areas introduced in Beijing in June 2015. Other mainland cities have taken similar measures at different times.

On Dec. 6, the Beijing Commission of Health and Family Planning said that more than 2,700 people had been fined for violating these restrictions, with total fines of 142,500 yuan, as of Nov. 30 this year.

Professor Dr Judith Mackay, based in Hong Kong and Asia’s leading anti-tobacco campaigner, said that the price of cigarettes in China is still extremely low.

“The latest small tobacco tax increase, while laudable, will not have a serious, sustained effect on reducing smoking. It is time to review the whole tobacco tax structure in China, significantly increase the price of cigarettes and thus protect the health of the Chinese people.

“In Australia, there is a regular increase of 12.5 per cent tobacco excise tax every year. The cost of a packet could soon rise to A$40 (HK$230). Hong Kong and China should both consider long-term tobacco tax planning in this way, so that tobacco control proceeds in an orderly form, and immense energy and time is not wasted year by year in campaigning for a tax increase. Otherwise, thousands will die.”

In Greece’s tobacco culture, passive smoke a serious problem

http://www.ekathimerini.com/214387/article/ekathimerini/news/in-greeces-tobacco-culture-passive-smoke-a-serious-problem

Nearly two-thirds of Greeks are inhaling someone else’s tobacco smoke on a daily basis, making Greece the worst nation in the European Union in exposing its people to the health risks of passive smoking.

The European Union’s statistical office Eurostat said Wednesday that 64.2 percent of Greeks suffered daily exposure to tobacco smoke indoors. Second in the EU is Croatia with 44.7 percent, followed by Bulgaria with 40.5 percent. At the other end, Sweden best protects its people from secondhand smoke with only 5.9 percent exposed, even better than Finland with 6.3 percent.

In a tally of EU smokers aged 15 and over, Bulgaria tops the rankings with 34.7 percent, ahead of Greece with 32.6 percent. Sweden only has 16.7 percent who smoke, with Britain the second-lowest with 17.2 percent.

1 in every 4 persons aged 15 or over in the European Union is a smoker

Download (PDF, 151KB)

One quarter of people living in the EU smoke tobacco, new statistics reveal

New statistics published on Wednesday by Eurostat, the European Union’s statistics office, reveal one quarter of people living in the EU smoke tobacco.

http://www.euronews.com/2016/12/07/one-quarter-of-people-living-in-the-eu-smoke-tobacco-reveal-new-statistics

In addition to those who smoke themselves, one in every five are passively exposed to tobacco smoke.

The new report measured how much those aged over 15 years old smoke. The data represents people’s habits in 2014. It was compiled between 2013 and 2015 and was extracted from the European Health Interview Survey.

Its findings indicate that nearly 24 percent of people in the EU smoke, when including those who only smoke occasionally. It also shows the share of men who smoke, is significantly higher than that of women.

The report, part of the European Health Interview Survey, adds that tobacco consumption is one of the largest avoidable health risks in the EU: many forms of cancer, cardiovascular and respiratory diseases are linked to tobacco use.

How it compares

The 2014 figures, when compared with the last time the EU looked at tobacco consumption in 2010, suggests a decreasing trend in tobacco usage among EU citizens.

Six years ago, 29 percent of people living in the EU considered themselves active smokers, nearly five percentage points higher than in the EU’s current evaluation.

The report also shows a drop in the percentage of smokers in the countries which previously had the highest population of tobacco users.

In Greece, 42 percent of those aged over 15 said they smoked in 2010. That number has dropped to 32 percent.

While still in the top two countries for tobacco consumption, this drop is significant and now places Greece below Bulgaria.

Sweden remains the country with the lowest percentage of smokers, with a consistent 16 percent of the population admitting to tobacco use in both surveys.

Here is a breakdown of the 2016 report data:

Smoking EU-wide: As percentage of population

smoking-habit

smoking-exposure

Percentage of population by country aged at least 15 years old…

Non-smoking/ Current smokers

current-eu-smoker-percentage

Daily exposure to tobacco smoke indoors within EU countries

percentage-population-plus-15

Total smoking in the EU according to gender

eu-daily-smoker

eu-non-smoker

eu-occasional-smoker

eu-smoker

FTC Releases 2014 Cigarette and Smokeless Tobacco Sales and Marketing Expenditures Reports

http://military-technologies.net/2016/11/28/ftc-releases-2014-cigarette-and-smokeless-tobacco-sales-and-marketing-expenditures-reports/

The number of cigarettes sold by the largest cigarette companies in the United States to wholesalers and retailers in the U.S. declined from 256.7 billion in 2013 to 253.8 billion in 2014, according to the most recent Federal Trade Commission Cigarette Report.

The amount spent on cigarette advertising and promotion decreased from $8.95 billion in 2013 to $8.49 billion in 2014, due mainly to a decrease in spending on price discounts (discounts paid to cigarette retailers or wholesalers in order to reduce the price of cigarettes to consumers).

Spending on price discounts decreased from $7.64 billion in 2013 to $6.76 billion in 2014. The price discount categories (retail and wholesale) were the two largest expenditure categories in 2014, accounting for 79.7 percent of industry spending in 2014. For the first time, this year’s report breaks out the retail ($5.56 billion) from wholesale ($1.20 billion) price discounts. Price discounts had been the single largest expenditure category every year since 2002.

According to the 2014 Smokeless Tobacco Report, smokeless tobacco sales declined slightly from 128.0 million pounds in 2013 to 127.8 million pounds in 2014. The revenue from those sales increased, however, from $3.26 billion in 2013 to $3.42 billion in 2014.

Spending on advertising and promotion by the major manufacturers of smokeless tobacco products in the U.S., which had increased from $435.9 million in 2012 to $503.2 million in 2013, further increased to $600.8 million in 2014. As with cigarettes, price discounts made up the two largest spending categories, totaling $357.2 million – or 59.4 percent of all spending in 2014, up from the $287.7 million spent in 2013. As with the cigarette report, this year’s smokeless tobacco report breaks down price discounts provided to retailers ($257.3 million) and to wholesalers ($99.8 million).

The Commission has issued the Cigarette Report periodically since 1967 and the Smokeless Tobacco Report periodically since 1987.

The Commission vote to issue the reports was 3-0. (FTC File No. P114508, the staff contact is Michael Ostheimer, 202-326-2699)

Myanmar ranks last in ASEAN tobacco control study

With out-of-date policies, cheap access, and ubiquitous usage, Myanmar ranks last in tobacco control, according to a survey of the region released last week.

http://www.mmtimes.com/index.php/national-news/23722-myanmar-ranks-last-in-asean-tobacco-control-study.html

The Southeast Asia Tobacco Control Alliance (SEATCA) study measures each of the ASEAN countries’ implementation of the World Health Organization (WHO) framework for tobacco control. Myanmar scored 45.7 out of 100, falling just behind the Philippines and Laos. Singapore topped the list with a score of 80.5.

Myanmar adopted the Control of Smoking and Consumption of Tobacco Product Law on May 4, 2006, to reduce the number of people using tobacco and tobacco-related products. The law contains rules on non-smoking areas and regulations to control the sale, production and advertising of tobacco products.

However, according to the SEATCA survey, Myanmar lags behind other countries in its banning of smoking in indoor workspaces, including bars and restaurants, and indoor public places. It is the only country that has not regularly updated its tobacco control policy and strategy, according to the study.

While it falls in the middle of the pack for taxation of tobacco products, Myanmar stands alone as the only country in the region that does not spend any public money on tobacco control, according to the study. And, despite the taxation, cigarettes are still fairly cheap: K2000 for a pack of Regular Marl¬boros and K800 for a pack of Red Ruby, the most popular brand in the country. Red Ruby’s are the cheapest cigarettes in the region.

The country is also middling in its ability to provide education or cessation programs.

According to the report, the government does not allow tobacco industry officials to sit on government committees or advisory groups that are deciding health policy.

However, the government does give preferential treatment to the tobacco industry, according to the report.

Like many of the other countries in the region, regulation of tobacco advertising and sponsorship goes unenforced in many mediums. Tobacco ads are banned in television, movies, print media, and billboards but there is no enforcement of tobacco advertising bans on the internet.

Regulations on the packaging of tobacco products, on the other hand, are fairly strong when compared with other countries in the region. A majority of the packaging is dedicated to raising awareness about the dangers of using tobacco.

In February, the government announced that new regulations would go into effect on September 1, requiring that health warnings and graphic photos illustrating the dangers of tobacco use must appear on all brands of cigarette and other tobacco products manufactured in Myanmar.

However, the tobacco companies asked for a six-month reprieve. The Department of Public Health told The Myanmar Times that following appeals from the companies – which cited a lack of awareness among retailers that they could face punishment if they sell incorrectly packaged products – the rules would not go into effect until February 2017.

Once the new law is in full effect, anyone involved in the production, distribution or sale of tobacco products that do not contain a graphic warning label could be subject to a fine of between K10,000 (US$7.95) and K30,000 for a first offence.

According to a 2014 survey, the rate of tobacco use in Myanmar is 26.1 percent of the population, including 43.8pc of men and 8.4pc of women.

Tobacco linked to 40 percent of all cancers diagnosed in U.S.

http://www.wilx.com/content/news/Tobacco-Cancer-Link-400772071.html

The number of people who smoke has fallen significantly, but tobacco use remains a factor in a large percentage of cancers.

A new report from the Centers for Disease Control links tobacco to 40-percent of all cancers diagnosed in the U.S.

Smoking doesn’t just cause lung cancer. It’s also linked to cancers of the mouth and throat, voice box, esophagus, stomach, kidney,

colon, bladder and even a form of leukemia.

C.D.C. data also shows fewer Americans are smoking. About 20-percent of adults smoked in 2005.

That number fell to 15-percent last year.

The Tobacco Control Atlas: ASEAN Region

Download (PDF, 11.39MB)

Big Tobacco sees its future in cigarettes, not vaping

http://theconversation.com/big-tobacco-sees-its-future-in-cigarettes-not-vaping-67363

In 2012, in the early days of the rise of e-cigarettes, Kingsley Wheaton, Director of Corporate and Regulatory Affairs at British American Tobacco, said “Our core business is, and will remain in, tobacco”.

So have the intervening four years made much difference? Apparently not.

This month, senior Philip Morris International executive Werner Barth told shareholders at its investor day presentations the company fully expected its cigarette brands to remain highly profitable. Investment analysts Motley Fool summarised the presentation by saying that Philip Morris planned to have cigarettes “keep bringing in the bulk of its revenue for years to come.”

In 2014, more than one billion smokers spent some $US744 billion on 5.6 trillion cigarettes. By contrast, the global e-cigarette market had estimated sales of $US6.1 billion in 2015 (0.8% of the cigarette market). Bullish forecasts about the future of e-cigarettes are easy to find on the internet. Many of these are undoubtedly efforts to attract investors.

But recent data point to a major slowing in the growth that has been seen in some nations for about five years. In the important US convenience store sector, sales of vapour products fell continuously for seven months (note that this data does not include online or vape shop sales).

A report earlier this year in the industry magazine Tobacco Reporter quoted a Euromonitor tobacco analyst saying:

Western Europe – for the first time in several years – saw positive [tobacco] volume growth as economies recovered and out-switching to illicit and vapour products lessened.

Barth highlighted three high-growth segments for cigarettes: low-tar cigarettes, which Motley Fool noted “have become an important way that some smokers have aimed to address their concerns about potential health impacts of smoking”; slimmer cigarettes (a strategy usually targeted at women); and the capsule market, where smokers can burst a capsule of flavour embedded in the filter.

Low-tar cigarettes have of course been thoroughly discredited as false and misleading harm-reduced products. The Australian Competition and Consumer Commission (ACCC) has banned the light and mild descriptors in Australia. The tobacco industry knew about this deception for decades (see below) but is apparently still happy to benefit from and not actively correct consumer misunderstandings here.

Big Tobacco knew 44 years ago that people did not smoke like tar measuring machines.  Legacy Industry Documents Library

Big Tobacco knew 44 years ago that people did not smoke like tar measuring machines. Legacy Industry Documents Library

In recent years we have seen an incontinence of rebirthing talk from Big Tobacco companies such as Philip Morris, British American Tobacco (BAT), RJ Reynolds and Japan Tobacco International about their commitment to manufacturing non-combustible nicotine delivery devices, particularly e-cigarettes and Philip Morris’ heat not burn products.

The hope for these products, like a conga line of hyped harm-reduction failures of the past, is that they will significantly reduce disease and death from what follows from nicotine addiction.

Tobacco companies of course all wish that two in three of their very best customers didn’t inconveniently die from using their products years earlier than normal life expectancy. They would much rather they could all keep smoking for a normal life span and keep the cash registers turning over.

For decades companies just denied that smoking killed. In the 1990s, these lies were stopped in their tracks when the companies were forced to publicly swallow truth serum in the form of their own newly public internal documents, released via whistleblowers and through litigation. These showed they knew the problems with tobacco all along.

If the industry really cares deeply about the deaths of its customers, this care is not enough to do anything to stop it selling the deadliest forms of nicotine delivery, nor to desist from its major attacks on tobacco-control policies it knows are most effective in reducing smoking. Plain packaging, which started in Australia, continues to attract massively funded attacks and legal challenges, currently in full swing in Canada which is nearing legislation.

Every day British American Tobacco’s twitter feeds around the world are choked with its best efforts to demonise tobacco tax rises, all in the hope that governments will reduce tobacco tax. This would see both smoking and the diseases it causes rise.

The very last thing that Big Tobacco hopes for harm-reduced nicotine products is that they will cannibalise their mainstay cigarette markets. Instead, the business model is dual use (people smoking where and when they can smoke, and vaping when they can’t); luring ex-smokers back as customers with promises of negligible harm from vapoursied nicotine products; and intriguing young people who have never used any nicotine product and who are increasingly never likely to, to start experimenting with vaping and hopefully doing it regularly.

In the United States, the latest National Youth Tobacco Survey shows the historically continuing fall in youth smoking has come to a screaming halt coincident with record use of e-cigarettes. The anxiety in the tobacco industry about this must be all-consuming.

There is now a small group of experts in public health who are now openly or covertly collaborating with the tobacco industry over e-cigarettes. They are being comprehensively played. In mouthing its newfound concern for tobacco’s harms, the industry’s harm-reduction division personnel can now cosy up to a suite of naïve or historically amnesic public heath urgers who lend Big Tobacco a credibility it craves.

Meanwhile, down the Big Tobacco corridor in the cigarette divisions, the harm-reduction staff’s colleagues continue promoting smoking and attempting to thwart effective tobacco control as usual.

This new, embarrassing and appeasing embrace is rather like charity leaders warmly embracing a mafia boss for his generous annual cheque, knowing full well from where the largesse was derived.