Clear The Air News Tobacco Blog Rotating Header Image

UK

Anti-smoking campaigner wins top award

http://scottishcancerfoundation.org.uk/news/anti-smoking-campaigner-wins-top-award/

An anti-tobacco campaigner who has played a leading role in reducing the harm caused by cigarettes in Scotland has been honoured by the Scottish Cancer Foundation.

Sheila Duffy, the chief executive of ASH Scotland, is this year’s recipient of Scottish Cancer Foundation prize which recognises individuals who have made an outstanding contribution in the fight against cancer.

Today, smoking rates in Scotland are half what they were in the 1970s and the number of young people taking up the habit is at the lowest level ever recorded. Meanwhile public support has grown for measures to regulate tobacco even further.

Sheila Duffy has been at the heart of these changes for the past 20 years. She played a prominent role in building the case in Scotland for the introduction of a smoking ban in enclosed public places in 2006 – the first part of the UK to introduce such a measure. It has been credited with changing attitudes to smoking and has been described as one of the most important public health changes of the past 100 years.

In addition Ms Duffy has campaigned successfully to move tobacco out of the reach of young people, enhance support for those who want to quit, and remove attractive branding from tobacco packaging which reduces its appeal, particularly to young people.

Professor Bob Steele, Chairman of the Scottish Cancer Foundation said: “Smoking causes or increases the risk of a range of cancers and it has been very pleasing to see the positive reductions that have taken place in tobacco use in Scotland in recent years. Sheila Duffy and the organisation she leads have been instrumental in many of these changes which will free hundreds of thousands of Scots from the fear of contracting tobacco related cancer.

“Her commitment has helped to make Scotland a healthier country and she is a very worthy winner of the Scottish Cancer Foundation prize.”

Ms Duffy said : “I am greatly honoured to receive this award, especially in 2016 as we celebrate ten years of smoke-free indoor spaces. Tobacco is the single biggest preventable cause of cancer, and working to put cigarettes out of sight, out of mind and out of fashion must be a priority going forward.”

“The national ambition is that a child born this year will grow up and reach the age of 18 smoke-free. Achieving this will prevent future cancers, and directly reduce health inequalities.”

The award comes with £10,000 prize money which is to be used to further reduce the burden of cancer in Scotland. Ms Duffy said that ASH Scotland plans to use the money on research to improve the help that can be given to people living in challenging circumstances. The smoking rate for the poorest fifth of the population is still 34%, amongst those with a long-term disability or unemployed it is nearly 50% and among prisoners it is 72%. A third of all tobacco used is by people with mental health issues.

The research will focus on factors that lead people in these groups to smoke and the barriers they face to stopping. It is hoped this will fill gaps in our current knowledge and lead to more effective measures to help them.

The Scottish Cancer Foundation prize is supported by the Grant Simpson Trust which helps organisations involved in the “advancement of health.”

The award to Ms Duffy was presented at the Scotland Against Cancer conference on November 21 at the Royal College of Surgeons of Edinburgh.

E-cigarette use linked to permanent lung damage in teenagers

http://www.grimsbytelegraph.co.uk/e-cigarette-use-linked-to-permanent-lung-damage-in-teenagers/story-29919152-detail/story.html

E-cigarette use has been linked to bronchitis in teenagers.

E-cigarettes have become ever-more popular in recent years with stores popping up all over North East Lincolnshire but teenagers who use them are far more likely to get bronchitis, a study has found.

Young people who vape have a 71 per cent higher risk of developing the condition than those who have never used an e-cig.

Researchers at the University Of Southern California analysed responses from more than 2,000 older teenagers asking for symptoms of chronic bronchitis, such as a regular cough for three months straight.

The study found that those who were using e-cigarettes were 85 per cent more likely to have had the lung infection. This dropped to 71 per cent when those who smoked regular cigarettes or were exposed to tobacco smoke were taken into account.

It is thought the chemical diacetyl, which is used to create e-cigarette flavourings, could be partly to blame.

Even teenagers who had used e-cigarettes but had stopped doing so were still 41 per cent more likely to report symptoms of bronchitis.

The findings are apparently similar to “popcorn lung” – a condition reported by popcorn factory workers who developed an incurable condition scarring their lungs due to exposure to diaceyl, which was used to give the snack its buttery flavour.

Dr Rob McConnell, professor of preventive medicine at the Keck School of Medicine, within the University of Southern California, said: “E-cigarettes are known to deliver chemicals toxic to the lungs, including oxidant metals, glycerol vapour, diketone flavouring compounds and nicotine.

“However, there has been little study of the chronic health effects of e-cigarettes.

“The Children’s Health Study provided an opportunity to examine bronchitic symptoms common among smokers to see if the risk was also increased in users of e-cigarettes.”

Researchers added that “additional study is needed to fully understand their long-term effects”.

Last year, Public Health England published a study saying vaping is 95 per cent less harmful than tobacco. They even went so far as to call for GPs to be able to prescribe e-cigarettes on the NHS to help people quit smoking.

Beating tobacco starts with going easy on vaping

http://www.thetimes.co.uk/edition/scotland/beating-tobacco-starts-with-going-easy-on-vaping-3gtx68ptc

Stopping smoking has always been a bit of a drag. White-knuckle determination to resist the need to smoke is accompanied by a bewildering variety of inhalers, gums, sprays, patches, tablets and counselling, much of which is associated with modest success and some of which has serious adverse side-effects.

Stopping smoking remains a global health priority since it is still the leading cause of premature death and serious ill health. With the advent of e-cigarettes, quitting smoking has become fun as smokers discover a world of user-modifiable e-cigarette kits and a limitless range of flavours. In a survey of more than 22,000 vapers carried out by researchers in Glasgow, smokers typically started vaping with high-nicotine, tobacco-flavoured e-liquids before progressing to zero-nicotine fruit flavours as they moved further away from the world of smoking.

Although they have helped millions to turn their back on tobacco, e-cigarettes have attracted controversy due to fears that they may attract non-smokers and lead to renormalisation of smoking. Government bodies in Europe and the United States are imposing restrictive regulations on e-cigarette production, sales and use that will limit the range of flavours and reduce access to the modifiable e-cigarette kits that vapers seem to enjoy.

At a World Health Organisation meeting in Delhi this month on tobacco control, delegates were asked to support a worldwide ban on e-cigarettes. Here in the UK, the appetite for regulation is enormous. Almost all council areas within the UK already maintain a ban on the use of e-cigarettes at work, leaving vapers to stand in the cold.

With Brexit, the UK has the opportunity to develop regulations governing e-cigarettes that can ensure that these devices remain widely available for smokers at the same time as their appeal to non-smokers is minimised.

Flavours are important, as are retaining the user-modifiable e-cigarette tanks that allow users to produce the voluminous vaper clouds that have become so characteristic of these devices.

We need to discourage e-cigarette use by non-smokers, not by forcing people to vape in hiding but by recognising what this technology is achieving in saving smokers’ lives.

Dr Neil McKeganey is director of the Centre for Substance Use Research in Glasgow

Vaping Clampdown? | Royal College of Physicians, John Britton Talks COP7

https://regulatorwatch.com/brent/vaping-clampdown-royal-college-physicians-john-britton-talks-cop7/

Is the World Health Organization poised to kill millions of people? Just as vapers in several countries began to feel like events may finally be turning in favor of e-cigarettes as a harm reduction tool, the harsh realities of the global public health movement shattered any optimism.

The World Health Organization is just wrapping its Conference of the Parties to the Framework Convention on Tobacco Control, known as COP7, in India and according to professor John Britton, Chair of the Tobacco Advisory Group at the Royal College of Physicians in Britain (RCP), the future for vaping looks bleak.

The RCP, Public Health England and the UK Centre for Tobacco and Alcohol Studies have all endorsed e-cigarettes as a vital tool in the battle to end the tobacco epidemic.

Tune in to this special edition of RegWatch and learn why officials from England’s top public health organizations fear that pending WHO regulatory action on e-cigarettes could kill millions of people.

PLAIN PACKS: ‘THE LAST BATTLEFIELD’

In 2008 Tobacco Journal International, splashed ‘Plain packs can kill your business’ on its front cover in response to the UK government consultation on such legislation.

The fear wasn’t the threat that sales would be hit hard, but that high end brand values would be terminally undermined. Why?

Because, exclusive packaging communicates brand image and differentiates high priced brands from value products’. To quote the article, “‘while the cost of production is roughly the same for both…. the profit margin of premium brands is considerably higher than that of low-priced cigarettes’.

The lesson is clear, the top priority for the transnational tobacco industry is profitability rather than sales. This is an industry which made US$ 44.1 billion in 2013, more the combined profits of Coca-Cola, Walt Disney, General Mills, FedEx, AT&T, Google, McDonald’s and Starbucks in the same year. And profits have been rising far more rapidly than sales.

Between 2000 and 2014, global cigarette volume sales increased by 8 percent while retail values increased 121 percent. A trend that plain packaging threatens to bring to a shuddering halt.

FCTC guidelines on Article 11 and 13 were adopted at COP3 in November 2008 encouraging Parties to go ahead with plain packaging. Four years later in 2012 it was Australia which led the way, followed by the UK and France in May 2016. The dominoes are now falling, with the Canadian Cancer Society report published this week showing that four countries now require plain packs (Australia, France, UK, and Hungary) with a another 14 more working on it.

The tobacco manufacturers are using any and every legal avenue to try to stop the contagion from spreading. So far there has been a constitutional challenge in Australia, a bilateral investment treaty case in Hong Kong, a cases in the European Court of Justice, and cases in the UK and French courts.

All so far lost (the World Trade Organisation government to government challenge, with the tobacco industry’s fingerprints all over it, is still pending). But make no mistake there will be others, for this is an existential threat to the tobacco industry described by one of their lawyers in the UK case as the ‘last battlefield’.

For any government hit by plain packaging litigation, the judgement in the UK provides a wealth of ammunition to take the fight to the industry. The central most important argument of the industry demolished by the judgement was that requiring plain packs was tantamount to stealing their ‘property’ and was either illegal or, if it were found to be legal, required multi-billion dollar compensation from the government in question.

Shamefully one of the industry lawyers even made a comparison to slavery, saying, “However strong the objective for taking property away, you will normally compensate,” he told the judge.

“Your lordship will remember the slave owners were compensated when slavery was abolished.” It was an unfortunate example and not one that impressed the judge who pointed out it was the UK parliament, dominated by slave owners, which agreed compensation, not the courts. Not a precedent any court around the world should follow.

Big tobacco’s profits were built on slavery: and while the owners were compensated, the victims of slavery were not.

For more on the UK court judgement see: tinyurl.com/zjgnxwn

Deborah Arnott
Action on Smoking and Health, UK

THE UNION’S INDEX OF TOBACCO CONTROL SUSTAINABILITY

The Index of Tobacco Control Sustainability (ITCS) is a new tool to assess and guide national tobacco control programmes and systems to become sustainable. It was developed to work for countries across the economic spectrum, using 31 indicators to identify whether the vital structures, policies and resources for sustainable national tobacco control programmes are present or absent. Through the ITCS’ comprehensive and holistic assessment, countries can draw out the information needed to strengthen and sustain their tobacco control systems. Importantly, the ITCS identifies infrastructural gaps as well as areas of strength.

After the ITCS was published in British Medical Journal Tobacco Control, it was piloted in 24 countries with the highest burden of tobacco use —an ITCS assessment was completed in each. The greater the number of indicators a country has in place, the greater its ITCS score. The higher a country’s total score the more likely it is to have a sustainable tobacco control programme. The greatest possible score is 130. Because MPOWER encompasses the key evidencebased strategies needed to reduce tobacco use, it is the most important factor for sustainable tobacco control.

Without at least four MPOWER policies in place a country cannot be sustainable, regardless of its score.

One possible limitation of the ITCS is that it identifies the presence or absence of key components for sustainable tobacco control —it does not assess quality. The rationale for this binary rating system: present or absent, is strong. It places emphasis on ensuring that the foundations for critical components are in place, and clearly identifies infrastructural gaps.

It also enables assessment across vastly varied countries.

If a component is pending at the moment of assessment, it is designated as absent. So an ITCS assessment should be viewed as a ‘snapshot in time’, capturing a moment in an evolving situation.

An ITCS assessment is only the start of the process; it sets a baseline from which the critical work can begin —to address the system gaps identified. Multiple assessments conducted over a number of years can track development.

FINDINGS OF THE 24 COUNTRY ASSESSMENTS:

Two countries achieved the ‘threshold’ of sustainability, and Vietnam is very close to this level.

All three are low0- and middleincome economies. This illustrates that financial resources may not be the sole, or even the primary factor, for sustainable tobacco control.

Several areas stand out as requiring action by many countries:

Critical measures for preventing tobacco industry interference were absent in many cases: no country has a WHO FCTC Article 5.3 policy covering all government  departments and few ban tobacco industry corporate social responsibility programmes. These gaps should be addressed as a priority, to ensure investments in tobacco control are not undermined.

Many countries had one of the two tax indicators, but few had both.

One is a good foundation, but with both tax policies in place, this most effective measure for reducing tobacco consumption will have assured long-term impact.

Other factors requiring action include: earmarking a national tobacco control budget; developing health promotion funds or similar; official involvement of civil society within national tobacco control committees; and prioritising capacity-building.

The ITCS was developed at the start of The Union’s second decade working in international tobacco control. As a partner in the Bloomberg Initiative to Reduce Tobacco Use we work with governments and civil society in low and middle income countries to help introduce and implement policies proven to reduce tobacco use. The ITCS is the work of Dr Angela Jackson-Morris and Dr Ehsan Latif of The Union’s Department of Tobacco Control.

Access the ITCS & 24 Country Assessments at www.tobaccofreeunion.org

Contact Dr Jackson-Morris ajackson-morris@theunion.org for more information on completing an assessment.

Just ONE puff of flavoured e-cigarette vapour ‘contains dangerous levels of cancer-causing chemicals’

Flavoured liquids used in the devices exposes smokers to “unacceptably high” levels of aldehydes, produced when a compound decomposes

https://www.thesun.co.uk/living/2156130/just-one-puff-of-flavoured-e-cigarette-vapour-contains-dangerous-levels-of-cancer-causing-chemicals/

JUST one drag of a flavoured e-cigarette exposes a smoker to “unacceptably high” levels of cancer-causing chemicals, experts warned today.

They found aerosols – commonly called vapours – produced by the devices contain the dangerous substances.

These toxic aldehydes, including formaldehyde, are produced during the chemical breakdown of the flavoured e-liquid during the rapid heating process that happens inside e-cigs.

Dr Andrey Khylstov, of the Desert Research Institute, Las Vegas, said: “One puff of any of the flavoured e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavouring compounds.”

His team found the production of toxic aldehydes “is exponentially dependent on the concentration of flavouring compounds”.

E-cigarette liquids are marketed in nearly 8,000 different flavours, according to a 2014 report by the World Health Organisation.

Recent reports show many of these flavours, such as Gummy Bear, Tutti Fruity, and Bubble Gum, to name a few, are especially appealing to teens and kids – encouraging them to use the devices.

Around 2.8million adults use the devices in the UK and a 2014 study revealed more kids aged 11 to 15 experimented with e-cigs than traditional cigarettes.

In the US, 16 per cent of high school students regularly vape – making them the most commonly used tobacco product in teenagers.

To examine the dangers, Dr Khylstov and his team measured the levels of aldehydes in vapour produced by three common e-cigs.

To determine if flavourings were to blame for producing the cancer-causing chemicals, the researchers tested five flavoured liquids, as well as two control unflavoured liquids.

Researcher Dr Vera Samburov explained: “To determine the specific role of the flavouring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavours.”

She said the devices used in the experiments were three of the most common types of e-cig.

Using a controlled system, the researchers were able to ensure the same level of “puff” each time, simulating common vaping conditions.

All tests revealed the level of cancer-causing chemicals produced by flavoured e-liquids exceeded limits set by American authorities, designed to protect against hazardous chemical exposure.

Dr Khylstov added: “These results demonstrate the need for further, thorough investigations of the effects of flavouring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapours.”

The findings are published in the journal Environmental Science and Technology.

TOBACCO AND DEVELOPMENT: A NEW ERA FOR THE FCTC

At COP7’s opening plenary, the UK fired the starting pistol on a new era for the Framework Convention on Tobacco Control (FCTC) within the 2030 Agenda for Sustainable Development by investing £15 million pounds (around US$18 million) into FCTC implementation between now and 2021.

This commitment cements the link between development and tobacco control, which was still emerging at previous COPs prior to agreement on the post-2015 development agenda. As the UK said in its statement to the COP, “The inclusion of the FCTC in the Sustainable Development Goals (SDGs) is a major step forward and recognises that tobacco use negatively impacts on health and development.”

The funding, which supports a new initiative to promote the implementation of the FCTC in low- and middle-income countries, comes from the UK’s aid budget (the UK is the only G7 country to have met the UN’s target to spend 0.7 percent of gross national income on overseas aid). It will be delivered by the FCTC Secretariat to directly support a number of Parties as well as initiatives to promote implementation of the treaty in all low- and middle-income countries.

A key target of the SDGs health goal is to accelerate implementation of the FCTC.

The Addis Ababa Action Agenda on Financing for Development goes further and states: “Price and tax measures on tobacco can be an effective  and important means to reduce tobacco consumption and health care costs, and represent a revenue stream for financing for development in many countries.” The UK has a lot to offer in tobacco control, with wide-ranging expertise in most areas of the FCTC, including some of the highest taxes in the world combined with a comprehensive and effective strategy to tackle illicit trade.

The Action Agenda also says Parties should strengthen implementation of the WHO FCTC and “support mechanisms to raise awareness and mobilize resources for the convention.” The UK, through its funding commitment, is taking a lead on this and we hope others will follow.

This funding comes at just the right time, as the COP moves from prioritising policy development to implementation. At previous COP sessions the majority of time during the six days of inter-governmental negotiations was dedicated to agreeing on best practices in tobacco control in the form of guidelines for implementation of various FCTC articles. At COP7, no guidelines will be discussed, aside from partial guidelines for Article 9 and 10 (product testing and regulation). At this COP we need to turn our attention instead to developing a coherent and consistent approach to supporting treaty implementation, a process which to date has been ad hoc and underfunded.

The COP will be covering a range of related and overlapping issues: Status on implementation

• Reporting and implementation review (a report from an expert group);
• Impact assessment (which is a key source of information about levels of implementation and gaps and challenges which need addressing for effective treaty implementation).

Mechanisms to support  implementation

• International co-operation for FCTC implementation;
• South-South and triangular co-operation;
• Sustainable measures to strengthen implementation (report of the working group); and
• Financial resources and mechanisms of assistance.

At COP7 we have the opportunity to re-examine how these issues interlink and to develop an efficient and holistic system that will maximise the synergies between them, working in collaboration with other members of the UN family, in particular WHO and the UN Development Programme. Such a system needs to underpin full implementation of the Treaty and provide maximum support to Parties. And we can do this secure in the knowledge that the funding has been provided by the UK to the Secretariat to get the ball rolling.

Deborah Arnott
ASH UK

Vaping raises likelihood of teenagers starting to smoke, study suggests

Research based on teenagers in California tentatively proposes link but experts say it does not prove that one leads to the other

https://www.theguardian.com/society/2016/nov/08/vaping-raises-likelihood-teenagers-smoke-cigarettes-study-suggests

A study of teenagers in California has tentatively suggested a link between vaping and starting to smoke cigarettes, although experts say it does not prove that one leads to the other.

About 37% of teens in the US have tried vaping, and there is widespread anxiety that young people who use e-cigarettes may be more likely to start smoking as a result.

The study, published in the Journal of the American Medical Association (JAMA), looked at vaping and smoking in more than 3,000 teenagers, aged about 15, in the 10th grade of 10 public high schools in Los Angeles county, California.

The numbers who vaped or smoked at all were small – only 26 who had never smoked at the beginning of the study said at the end of the follow-up period, six months later, that they had used e-cigarettes and also smoked in the previous month. Others had previously smoked infrequently or frequently.

But the researchers did find a trend. The more the teenagers said they had vaped, the more likely they were to smoke cigarettes. The more frequent vapers were also likely to smoke more heavily.

The public health community is divided over the pros and cons of e-cigarettes. Some doctors believe they may be the best tool yet for helping established smokers quit the habit, but others are less convinced and warn they could be a means of hooking non-smokers into a tobacco habit.

The authors of the study – Adam Leventhal, of the University of Southern California Keck School of Medicine, and colleagues – acknowledge there are many unknowns but conclude that: “The transition from vaping to smoking may warrant particular attention in tobacco control policy.”

Why can’t scientists agree on e-cigarettes?

Other experts said although the study was well conducted, it could not explain the link. “This study could not tell us if it is something about the young people that vape that predisposes them to smoking or that vaping itself makes smoking more likely,” said Paul Aveyard, professor of behavioural medicine at the University of Oxford. It was well known that teenagers who tried one risky behaviour were more likely to be willing to try another.

“Smoking in young people has fallen in the UK and the US to record lows in the past few years, despite the rise in prevalence of young people experimenting with e-cigarettes,” he said.

“Very few young people who do not smoke cigarettes become regular users of e-cigarettes. In this context, we should not worry unduly about this study’s findings, but it is important to monitor smoking in young people and its relationship with e-cigarette use.”

Prof John Britton, director of the UK centre for tobacco and alcohol studies at the University of Nottingham, said the study “doesn’t tell us whether vaping caused these young people to start smoking, or whether they would have started smoking anyway; or whether vaping prevented some young people who would otherwise have become smokers from progressing to tobacco smoking.”

Children whose parents were smokers and trying to give up would be more likely to have access to e-cigarettes – and also more at risk of starting to smoke in the first place.

“The key question is whether vaping is increasing smoking uptake, over and above that underlying risk,” said Britton. “This study doesn’t answer that question; but it does show that if it does, the proportions of children affected are very small.”

Groups demand tobacco lobbyist stops claiming links

Nestlé and the World Bank are among a number of organisations to demand that a controversial lobby group for tobacco companies stops claiming links to them.

https://www.ft.com/content/c9d6e11a-a1bb-11e6-82c3-4351ce86813f

The International Tax and Investment Center, which describes itself as a “non-profit research and educational organisation” that gives clients “a seat at the policymaking table”, has claimed on its website to “work closely” with the World Bank. It also listed Nestlé, law firm Pinsent Masons and the UK Department for International Development as its sponsors.

However, when Tax Justice Network wrote to sponsors and affiliated bodies asking if they were aware of the claims, all four organisations said they had no ongoing relationship with the lobby group.

ITIC works with organisations in a range of industries. But, in 2014, it was publicly denounced by the World Health Organisation for promoting “false” information on behalf of the tobacco industry. “ITIC has published extensively in favour of the tobacco industry’s false positions on excise taxation, investment and illicit trade in tobacco products,” said Dr Douglas Bettcher, a director at the WHO.

Around this time, some organisations ended their dealings with ITIC. The World Bank withdrew from an ITIC-organised event in 2015, and told Tax Justice Network: “The World Bank Group does not have a formal partnership with ITIC.” Timothy Evans, writing on behalf of World Bank president Dr Jim Yong Kim, said: “We have, in fact, previously contacted ITIC requesting that they remove the name of the World Bank Group from their homepage.”

Nestlé, which ITIC listed as a sponsor until earlier this year, said it had ceased contributing to ITIC in 2014. It said it had “taken action” over use of its logo on ITIC’s website.

Law firm Pinsent Masons was listed as a sponsor as recently as 2016, but ceased contributions to ITIC in 2013.

ITIC said it had agreed to comply with the World Bank’s request to remove its name, but “inadvertently missed” a reference when updating its site. It said Nestlé’s name had remained on the ITIC website for 24 months after its last payment to comply with ITIC’s policy of being “transparent”.

When asked why Pinsent Masons was listed as a sponsor more than 24 months after ending its relationship with the group, Daniel Witt, ITIC’s president, said it “certainly was not a conscious decision to leave them on the list”. ITIC has since removed references to all of the organisations from its website.

Critics have accused ITIC of publicising links with high-profile bodies to boost its image when lobbying governments. “Central to ITIC’s credibility with policymakers is the claim that they work closely with leading international organisations,” said Alex Cobham at the Tax Justice Network. ITIC denies this.

The UK Department for International Development was listed as a sponsor, despite having never given ITIC any money. In 2013, then secretary of state, Justine Greening, said she would demand that ITIC take down the website listing.

ITIC says it received funding from DfID’s “predecessor”, the UK Know-How Fund. DfID acknowledges that this fund made payments to ITIC, but says DfID itself had never sponsored ITIC.