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E-cigarette use threatens years of US anti-smoking gains, says report

Dec 8th, 2016
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Top US health officials have war ned that the gr owing use of e-cigarettes among young adults will undo decades of pr ogr ess in ending the ‘tobacco epidemic’

Growing e-cigarette use among young people threatens decades of progress in shrinking tobacco use, top US health officials warned in a report released on Thursday.

The US surgeon general’s report is the first federal government review of the public health impact of e-cigarettes on young people across the country.

“Preventing tobacco use in any form among youth and young adults is critical to ending the tobacco epidemic in the United States,” said surgeon general Vivek Murthy.

E-cigarettes don’t contain tobacco, but do contain nicotine and are considered “tobacco products” by the US government.

Advocates say e-cigarettes could replace traditional cigarettes, while critics are concerned they are a gateway to tobacco use – especially in young people, who are more vulnerable to the addictive impact of nicotine.

The debate over the potential harms and benefits of e-cigarettes is a live one in the US and the UK. Many public health professionals in the UK believe that vaping is the best available option for those who would otherwise smoke tobacco, and that it is saving thousands of lives by enabling hardened smokers to quit. Public Health England has said it is 95% safer, and that the young people experimenting with e-cigarettes are the same people who try smoking tobacco.

“Evidence from the US is the same as in the UK in crucial respects,” said Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies at Nottingham University. “Children experimenting with e-cigarettes are by and large those who are already experimenting with cigarettes or are smokers.”

The surgeon general’s report said e-cigarettes are the most commonly used tobacco product among the young and are more popular than cigarettes, cigars and hookahs in the US. The use of e-cigarettes and other nicotine products by under-18s has jumped significantly after decades of declining rates of cigarette smoking.

Young people are not using the products for the same reasons as adults, the report said: “Although adults report using e-cigarettes as a cessation device, the evidence supporting the effectiveness of e-cigarettes as an aid for quitting conventional cigarettes remains unproven and nonexistent among youth.”

The most common reasons for young people to use e-cigarettes are curiosity, to avoid indoor smoking restrictions and as a less harmful alternative to conventional cigarettes, according to the report.

In 2014, use of e-cigarettes by young adults aged 18 to 24 surpassed that of adults aged 25 and older.

Sylvia Burwell, the US Department of Health and Human Services secretary, said the US must ensure progress in combatting traditional cigarette use isn’t compromised by the use of new tobacco products like e-cigarettes.

“The findings from this report reinforce the need to support evidence-based programs to prevent youth and young adults from using tobacco in any form, including e-cigarettes,” Burwell wrote. “The health and wellbeing of our nation’s young people depend on it.”

Kevin Fenton, national director of health and wellbeing at Public Health England, said the group recognised the concern in the US, where it had proved difficult to impose restrictions on the marketing of e-cigarettes. By contrast, England had put in place a ban on marketing to under-18s, advertising controls and quality standards. But, he said, “our review of the evidence found e-cigarette use carries a fraction of the risk of smoking, a conclusion reiterated by the Royal College of Physicians earlier this year.

No new evidence has been published to contradict this, however we are closely monitoring any emerging evidence.”

The US report’s findings pull from existing research on e-cigarette use among people aged between 11 and 24 to show patterns of use and how it affects health.

This report was crafted in a similar vein to earlier surgeon general reports on youth tobacco use. The most recent of those was released in 2012, when e-cigarettes were less popular than they are now.

E-cigarette sales in the US grew to an estimated $3.5bn in 2015, according to Nielsen, but have been falling significantly since the end of last year.

The e-cigarette industry is dominated by traditional tobacco companies, who were targeted in the report for using similar tactics as those used to lure young users to tobacco. “Companies are promoting their products through television and radio advertisements that use celebrities, sexual content, and claims of independence to glamorize these addictive products and make them appealing to young people,” said Centers for Disease Control and Prevention director, Thomas Frieden, in the report’s foreword.

The report concludes with recommendations for combatting e-cigarette use among young people, including incorporating e-cigarettes into smoke-free policies, preventing youth access to e-cigarettes and significant increases to taxes and prices affiliated with e-cigarettes.

Murthy said: “Preventing tobacco use in any form among youth and young adults is critical to ending the tobacco epidemic in the United States.”

The report was launched on Thursday morning in Washington DC at an event where the surgeon general unveiled a new e-cigarette website and public service announcement. Speakers included Murthy, 16-year-old health activist Tyra Nicolay and American Academy of Pediatrics president Benard Dreyer.

Tyra, a member of the Navajo Nation, described how she was first introduced to e-cigarettes with a sour green apple flavored product but has since quit using e-cigarettes.

“Today, I call on my peers to reject tobacco products, including e-cigarettes,” she said.

Dreyer said e-cigarette use “has raised alarm among pediatricians, tremendously”.

In October 2015, the AAP issued recommendations for e-cigarette public policy and regulations and guidance for physicians on how to speak with families about tobacco and “nicotine delivery devices” such as e-cigarettes.

“That’s why this report is so necessary and welcome at this time,” Dreyer said. “Because as you’ve heard, e-cigarettes have the potential to addict the next generation of children. It’s a major public health crisis, as far as we’re concerned.”

The British campaigning organisation Action on Smoking and Health said it was puzzled by the surgeon general’s concerns. “In the US as in the UK, young people are experimenting with e-cigarettes but vaping has not been associated with an increase in smoking, a point which is not made sufficiently clear in the report,” it said.

“While nicotine is not completely harmless, it is smoking that is lethal. In the UK we have a regulatory system that restricts advertising and controls sales to young people.

There is no evidence of significant regular use by nonsmoking children and, as in the US, smoking rates are going down, not up.”

Britton, the Nottingham University academic, attributed a drop in the UK smoking rate, down three percentage points in three years, to people taking up e-cigarettes in order to quit. “It is falling fast in the UK, almost certainly related to e-cigarettes.”

National Cancer Institute – The Economics of Tobacco and Tobacco Control

Dec 1st, 2016
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Smoking parents linked to severe asthma

Nov 29th, 2016
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A third of children who have potentially fatal asthma attacks are being exposed to tobacco smoke, a new report has found.

https://au.news.yahoo.com/world/a/33355337/smoking-parents-linked-to-severe-asthma/#page1

Children’s doctors have become “complacent” in the need to advise parents about the hazards of smoke exposure among children with asthma, according to a new audit from the British Thoracic Society (BTS).

The review has prompted a call for health workers to do more to inform parents about the health risks of second-hand smoke to their children.

Experts reviewed data on 5,500 children admitted to 153 hospitals across the UK with severe asthma attacks in November 2015.

They found that 32 per cent had been exposed to environmental tobacco smoke.

The authors point out that passive smoking is “recognised as an important factor in asthma attacks in children that lead to hospitalisation”.

But two in five hospitals failed to record data on this issue, meaning doctors might need to pay greater attention to asking about exposure to tobacco smoke, they said.

The authors conclude: “Paediatricians may have become complacent about the need to record and advise parents about the hazards of smoke exposure in children with wheezing/asthma.”

Dr James Paton, reader in paediatric respiratory medicine at the University of Glasgow, who led the BTS audit, said: “It’s very worrying that a third of children were potentially exposed to tobacco smoke at home, although more data is needed here.

“When discharging children, health professionals should take the opportunity to talk about the issue with their parents or carers – and offer smoking cessation support as appropriate.”

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

Nov 28th, 2016
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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)

Secret report shows Big Tobacco targeted city politicians in Sudbury and Sault

Nov 25th, 2016
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Algoma municipalities are being asked to stub out all motions proposed by tobacco companies or front groups that slip demands for a freeze on excise taxes into campaigns against contraband tobacco.

https://www.sudbury.com/around-the-north/leaked-report-reveals-big-tobacco-targeted-city-politicians-in-sudbury-and-sault-473527

Leaked map shows 10 Ontario 'strategic municipalities' whose local politicians were targeted in 2012 by Imperial Tobacco Canada. Reasons for selecting these targets included their 'proximity to illicit tobacco' and 'likelihood of buy-in.'

Leaked map shows 10 Ontario ‘strategic municipalities’ whose local politicians were targeted in 2012 by Imperial Tobacco Canada. Reasons for selecting these targets included their ‘proximity to illicit tobacco’ and ‘likelihood of buy-in.’

Greater Sudbury has the dubious distinction of being named in a secret Big Tobacco document aimed, ostensibly, at fighting contraband smokes, but at the same time quietly lobbying to freeze the excise tax on legitimate tobacco products.

Algoma Board of Health, the governing body of Algoma Public Health, is warning area politicians about new evidence linking Imperial Tobacco Canada Ltd. to lobbying campaigns against contraband tobacco.

The health board voted this week to ask Algoma municipalities to reject all motions received from tobacco companies or front groups that spike campaigns against illicit smokes with demands for a tobacco excise tax freeze or limits on regulation of tobacco products.

Imperial Tobacco Canada Ltd. is a wholly-owned subsidiary of British American Tobacco Plc., one of the world’s five biggest tobacco companies with 55,000 employees in 44 factories in 41 countries.

In a recently leaked internal report prepared for its London-based parent, Imperial Tobacco Canada reveals that it’s been quietly involved for years in lobbying campaigns by convenience-store and anti-contraband groups.

The secret report describes Project M&M, a 2012 campaign intended to “mobilize local governments to pressure for big government action” against illicit tobacco, with demands for an excise tax freeze piggybacked on the main message.

Listed as partners in Project M&M are the Canadian Convenience Store Association, the National Coalition Against Contraband Tobacco, the Ontario Chamber of Commerce, Fédération des Chambres de Commerce du Québec and the Canadian Taxpayers Federation.

The leaked 32-page document includes a map identifying 10 “strategic municipalities” to be targeted in Ontario: Sault Ste. Marie, Sudbury, Windsor, Brantford, London, Mississauga, Niagara Falls, Whitby, Cornwall and Toronto.

These municipalities were selected, the report says, because of their:

  • proximity to illicit tobacco
  • seizure activity
  • internal sales data
  • political weight
  • likelihood of buy-in

The document also identifies 10 targeted municipalities in Quebec: Montreal, Gatineau, Chateauguay, Laval, St. Georges, Sherbrooke, Quebec City, Drummondville, Trois Rivieres and Saguenay.

An article published one month ago by the National Post pointed to other close ties between convenience-store organizations and the tobacco industry.

“In fact, there is other evidence of their close links to the industry, including at least three former tobacco-company executives who are now leaders in the Ontario, Quebec and national convenience-store associations,” the Post’s Tom Blackwell reported.

The leaked Imperial Tobacco report suggests that the “2012 lobbying campaign was no grassroots movement, and that the retail and contraband organizations have for years been used as surrogates by the cigarette giant to promote its own interests,” Blackwell wrote.

Sales of illicit cigarettes are considered a major problem in Ontario, where a bag of 200 illegal “rollies” sells for as little as $10 to $15, compared to more than $80 for legally taxed smokes bought at a corner store.

A 2013 study of collected cigarette butts conducted by NIRIC Group for the Ontario Convenience Store Association found that 17.7 per cent of butts picked up in Sault Ste. Marie were contraband, compared to 30.1 per cent in Kitchener, 28.5 per cent in Barrie, 24.5 per cent in Sudbury, 20.9 percent in Thunder Bay, 18.7 per cent in Toronto, 18.1 per cent in Guelph and 11 per cent in North Bay.

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

Nov 10th, 2016
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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.

Tobacco plain packaging catching on worldwide: Canadian Cancer Society report

Nov 9th, 2016
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http://www.marketwatch.com/story/tobacco-plain-packaging-catching-on-worldwide-canadian-cancer-society-report-2016-11-09

The trend to reduce smoking and cancer rates by forcing tobacco companies to use plain packaging is gaining momentum across the globe, concludes an international report released today by the Canadian Cancer Society. The report shows that 4 countries have plain packaging laws in place and 14 others are working on it.

Plain packaging requirements prevent tobacco companies from using colours, logos and design elements to market their cancer-causing products. The shape of the package must be in a standardized format, outlawing sales tactics such as slim packs appealing to girls and young women. Health warnings still appear on plain packages.

“Plain packaging is a global trend and it is coming to Canada, too,” says Rob Cunningham, senior policy analyst, Canadian Cancer Society. “We must continue to show leadership in the fight against the marketing of tobacco.”

In 2001 Canada was the first country in the world to implement graphic picture warnings on cigarette packages. Since then, more than 100 countries and territories (105 in total) have followed Canada’s lead – accounting for 58% of the world’s population – as illustrated in this graph. Canada’s leadership in graphic picture warnings has resulted in enormous health benefits globally.

Smoking is the leading cause of preventable disease and death in Canada, including about 30% of all cancer deaths and 85% of lung cancer cases. Tobacco kills 37,000 Canadians every year.

Tobacco packaging is one of the last and most effective ways for companies to promote their products, with eye-catching logos and colours designed to appeal to consumers. Plain packaging reduces tobacco use by eliminating promotion on packaging, reducing product appeal, curbing package deception, and increasing the impact of health warnings. Research shows that plain packaging works.

“Plain packaging is a crucial next step for Canada to reduce smoking and save lives,” says Cunningham. “We strongly support the federal government’s commitment to follow the lead of Australia and other countries to implement plain packaging to curtail the marketing of these cancer-causing products.”

Plain packaging is required in Australia, the United Kingdom and France, and will be by 2018 in Hungary. The 14 countries working on plain packaging are Canada, New Zealand, Ireland, Norway, Slovenia, Uruguay, Thailand, Singapore, Belgium, Romania, Turkey, Finland, Chile and South Africa.

Canada’s federal government included a commitment to plain packaging as part of its 2015 election platform. After forming a government, Prime Minister Justin Trudeau identified it as a “top priority” in a mandate letter to Health Minister Jane Philpott. On May 31, 2016 – World No Tobacco Day – Minister Philpott launched a 3-month public consultation on plain packaging. The federal government is now reviewing the responses and developing regulations.

The Canadian Cancer Society report released today – Cigarette Package Health Warnings: International Status Report – ranks 205 countries and territories based on the size of their health warnings on cigarette packages and lists countries that have finalized requirements for picture warnings. Canada ties for 8th in the world with package warnings that cover 75% of the package’s front and back. Nepal and Vanuatu are tied for top spot with a warning size of 90%, while India and Thailand are 3rd at 85%. The United States is in last place with minimal requirements for health warnings on either the front or back of the package.

The Canadian Cancer Society is calling for plain packaging to be implemented in Canada as part of a strengthened Federal Tobacco Control Strategy, which should also include increased funding to support additional programming and policy measures. Health Canada’s current strategy expires on March 31, 2018. The existing Tobacco Act is 2 decades old and must be modernized.

The Society’s report, published every 2 years, reviews and ranks cigarette health warnings internationally and tracks developments in this important area of tobacco control.

Other report highlights include:

94 countries and territories require warnings to cover at least 50% of the package front and back (on average), up from 60 countries in 2014 and 24 in 2008. — The top countries ranked in terms of warning size (as an average of the front and back of the package) are: 1. 90% Nepal 1. 90% Vanuatu (effective in 2017)

3. 85% Thailand 3. 85% India 5. 82.5% Australia (75% of front, 90% of back) 6. 80% Sri Lanka 6. 80% Uruguay 8. 75% Brunei 8. 75% Canada 8. 75% Laos 8. 75% Myanmar
The Canadian Cancer Society’s report was released today in Delhi, India, at the 7th session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control being held Nov. 7-12. The report was released to support implementation of the WHO Framework Convention on Tobacco Control, ratified by 180 countries. The goal of this international treaty is to control the global tobacco epidemic. Its guidelines recommend that parties consider implementing plain packaging.

Cigarette Package Health Warnings report in English Cigarette Package Health Warnings report in French

About the Canadian Cancer SocietyThe Society is a national, community-based organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of people living with cancer. Thanks to our donors and volunteers, the Society has the most impact, against the most cancers, in the most communities in Canada. For more information, visit cancer.ca or call our toll-free bilingual Cancer Information Service at 1-888-939-3333 (TTY 1-866-786-3934).

SOURCE Canadian Cancer Society (National Office)

Global demand for cigarette graphic warnings grows

Nov 9th, 2016
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http://www.fctc.org/fca-news/opinion-pieces/1476-demand-for-global-cigarette-graphic-warnings-grow

Over 100 countries and territories now require cigarette picture health warnings, marking a significant milestone in global public health that will reduce smoking and save lives.

The Canadian Cancer Society (CCS) has released a report ranking 205 countries and territories on the size of their health warnings on cigarette packages, and listing countries and territories that require graphic picture warnings.

The report shows significant global momentum toward plain packaging, with four countries requiring plain packs and 14 working on the measure.

“There is a powerful, worldwide trend for countries to use graphic pictures on cigarette packages to show the devastating health effects of smoking, and to require plain packaging,” says CCS’s senior policy analyst Rob Cunningham.

Examples of graphic picture warnings include a diseased lung or mouth, a patient with lung cancer in a hospital bed and a child being exposed to secondhand smoke. The report also reveals that many countries have increased the size of picture warnings on cigarette packages – and these larger pictures are known to be more effective.

Cigarette package warnings are a highly cost-effective way to increase awareness of the negative health effects of smoking and to reduce tobacco use. Picture-based warnings convey a more powerful message than a text-only warning, and larger ones increase impact.

Other report highlights include:

  • 105 countries and territories have finalized picture warning requirements, an increase from the 77 that had implemented these requirements by the end of 2014. In 2001, Canada was the first country to require picture warnings and to require a 50 percent size.
  • 58 percent of the world’s population is covered by the 105 countries and territories that have finalized picture warning requirements.
  • Nepal has the largest warnings in the world with picture warnings covering 90 percent of the package front and back. Vanuatu will also require 90 percent picture warnings in 2017. India and Thailand have the next largest warnings at 85 percent of the front and back.
  • 94 countries and territories require warnings to cover at least 50 percent of the package front and back (on average), up from 60 countries in 2014 and 24 in 2008.
  • Implementation by most European Union (EU) countries of the new EU requirement for 65 percent picture warnings was an important development contributing to the increase since 2014 in the number of countries requiring picture warnings.

– See more at: http://www.fctc.org/fca-news/opinion-pieces/1476-demand-for-global-cigarette-graphic-warnings-grow#sthash.luIWNxze.dpuf

Vaping does not help people stop smoking, says WHO report

Nov 4th, 2016
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Critics say World Health Organisation report is a backward step that will hamper fight to cut tobacco-related deaths

Countries might also want to ban nicotine delivery devices from all public places where smoking is not allowed, the report said.

https://www.theguardian.com/society/2016/nov/04/vaping-does-not-help-people-stop-smoking-says-who-report

Countries should consider curbing the use of e-cigarettes because there is not enough evidence to show they help people stop smoking, according to a World Health Organisation report.

Vaping will be on the agenda of a major meeting starting in India on Monday of the 180 countries that have signed the Framework Convention on Tobacco Control, aimed at combatting Big Tobacco and preventing the millions of deaths every year around the world caused by smoking.

But the public health community is split over whether e-cigarettes are friend or foe and some are outraged by the WHO’s advice to the meeting. It suggests countries that have not already banned e-cigarettes and other forms of nicotine delivery might want to consider imposing severe restrictions, including banning the flavouring of e-cigarettes as well as sales, advertising and possession by young people.

Countries might also want to ban nicotine delivery devices from all public places where smoking is not allowed, require health warnings about the chemicals in them, include information on the addictive potential of nicotine and ban any claims that they can help people give up tobacco smoking, the report says.

The WHO suggests these are reasonable measures to control the use of products with effects that are still unknown – and which are increasingly being manufactured by the multinational tobacco corporations the signatories to the convention are pledged to defeat.

But for some in the public health community, WHO’s report is a backward step that will hamper the fight to cut tobacco-related deaths.

Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies based at Nottingham University, said the WHO report was unbalanced. “There is nothing saying e-cigarettes are allowing hundreds of thousands of people to stop smoking,” he said.

The convention exists to combat tobacco use, not nicotine use, he said. “It is perfectly reasonable to be concerned that young people might use e-cigarettes and become addicted. All those arguments apply to licensed nicotine products that anybody can walk into Tesco and buy.” But nicotine regulation is for other agencies, he said.

Britton is concerned about the “flavour” of the WHO document “which is that these products are out there, they are being produced by tobacco companies and we should probably ban them – or if not, here are some regulations that you might want to introduce.”

The meeting in Delhi will be a conference of the parties (COP) that have signed the treaty, which includes national governments and the European Union. It takes place every two years to decide the future direction of tobacco control. The WHO report was written at the request of the parties who wanted to know about the scientific evidence for or against nicotine-delivery devices, said Dr Vera Luiza da Costa e Silva, head of the convention secretariat.

“So far there is a clear understanding that e-cigarettes should be regulated,” she said. “They should not be promoted among young people and pregnant women and other specific groups. They should not be promoted widely – there should be restrictions and regulations.” More monitoring of the effects and possible health benefits is needed, she said.

“While I don’t think COP will close the door [to e-cigarettes], I don’t think COP will open the door to them at this time,” she said.

The issue splits the public health community. Critics of e-cigarettes are concerned that they may be a “stalking horse” for Big Tobacco, which the Framework Convention has made a pariah.

Countries that have signed the treaty agree under Article 5.3 that the tobacco industry is beyond the pale and must never be allowed into negotiations. If e-cigarettes can help people stop smoking, the tobacco companies can argue for their rehabilitation and a presence at the table.

“While e-cigarettes offer a significant opportunity to public health, there are also risks. One is the way the tobacco industry uses harm reduction to secure reputational and access possibilities and to split the public health camp,” said Anna Gilmore, professor of public health at the University of Bath and the UK Centre for Tobacco Control Studies.

“The tobacco industry uses e-cigarettes to claim it is committed to harm reduction, but meanwhile it continues to engage in harm maximisation by spending millions to promote tobacco and oppose any policy that would reduce its use.”

Ahead of the Delhi meeting, rightwing thinktanks and libertarian groups have been on the attack, arguing that the COP is secretive and not transparent, because members of the public may be excluded from the proceedings. But, says Gilmore, that is because the industry and its representatives have to be kept out of the COP discussion, under Article 5.3, “yet we know the industry infiltrates these meetings often using third parties as a disguise,” said Gilmore.

It is impossible to screen every individual and group who wants to attend. “They are caught between a rock and a hard place, because of the industry’s underhand tactics,” she said.

The Tobacco Control Atlas: ASEAN Region

Nov 1st, 2016
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