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Passive Smoking

Indonesia’s Child Tobacco Workers in Peril

In the next week, Indonesian President Joko (“Jokowi”) Widodo will decide whether to encourage parliament to move forward with a draft tobacco bill aimed at increasing domestic tobacco production. The bill would gut many important existing health regulations, like the requirement that companies include a health warning with a picture on the label of tobacco products.

Those are troubling proposals given that millions of children in Indonesia start smoking each year, and that 40 million more are “passive smokers” from secondhand smoke. The Indonesian Ministry of Health, 17 prominent health organizations, and many others have denounced the measure as an attempt to undermine Indonesia’s already weak tobacco control laws. Jokowi should reject the bill.

But the draft bill is not the only tobacco policy issue awaiting action by the Jokowi administration. Each year in Indonesia, thousands of children, some just 8 years old, work in hazardous conditions producing tobacco that ends up in products marketed and sold by huge Indonesian and multinational tobacco companies.

My colleagues and I published a Human Rights Watch report documenting hazardous child labor on Indonesian tobacco farms last May. Since then, another tobacco season has come and gone, but the child workers behind Indonesia’s tobacco industry remain unprotected.

We interviewed 132 children who worked on tobacco farms in four of Indonesia’s biggest tobacco-producing provinces. We found that child workers are exposed to nicotine and pesticides—toxins that can be especially harmful to children who are still growing and developing. Half the children we interviewed had experienced nausea, vomiting, headaches, or dizziness while they worked. Those symptoms are consistent with acute nicotine poisoning, which happens when workers handle tobacco plants and absorb nicotine through their skin. Many children said they also mixed and sprayed toxic chemicals on the plants with no protective equipment, and some became violently ill afterward.

The families we interviewed did not intentionally put their children in harm’s way. They were committed to helping their children get an education so they could have a better future.

Indeed, most of the children we interviewed attended school and worked in tobacco farming only outside of school hours.

But direct contact with tobacco in any form is hazardous work for children because of the nicotine in the leaves. Most of the families we spoke with had never received comprehensive information about the hazards for children of work on tobacco farms, so they did not know the risks to their children.

We urged the Jokowi government to take action to protect children from danger in tobacco fields. We called on the Health Ministry to work with other ministries to develop a public education campaign to raise awareness of the dangers to children of work on tobacco farms. In recent meetings with Human Rights Watch, government officials have said they need additional support and resources to get the campaign underway this year.

Indonesia already prohibits children under 18 from work “with harmful chemical substances.” The Ministry of Manpower and Transmigration should explicitly prohibit children from working in direct contact with tobacco in any form and increase labor enforcement efforts to make sure government inspectors check for workers’ safety, especially on small tobacco farms where children might be in danger.

In our meetings with government officials, we have heard many times that the tobacco industry is powerful in Indonesia, and that it is difficult to achieve policy changes the industry opposes. Surely eliminating child labor in tobacco farming is an issue tobacco companies also want to address.

The UN Guiding Principles on Business and Human Rights make clear that companies have responsibilities for addressing human rights abuses in their supply chains. We shared our findings with the largest tobacco companies operating in Indonesia—Djarum, Gudang Garam, Philip Morris International (which owns Sampoerna), British American Tobacco (which owns Bentoel), and others. The large multinational tobacco companies have policies to prevent children from doing the most dangerous tasks on tobacco farms, but their policies are not strong enough, and they should do more to monitor for child labor when they buy Indonesian tobacco on the open market through traders.

The largest Indonesian companies—Djarum and Gudang Garam—do not appear to be taking any steps to prevent or address child labor in their supply chains. They have never responded to our many requests for information and meetings, and they do not make any information publicly available about their child labor policies.

These companies should not be profiting off the backs of Indonesian child workers.

Two months from now, the next tobacco-growing season will be underway, and children will be heading to the fields again. The controversy around the draft tobacco bill likely will not be resolved by then. But with decisive action, the Jokowi administration and tobacco companies could take steps to protect children from dangerous work in tobacco fields. Their futures depend on it.

Tobacco Smoke Ups Rhinitis Rates in Asian Children

Tobacco smoke is associated with pediatric rhinitis among Asian children, according to cohort study findings presented at the 2017 AAAAI Annual Meeting

http://www.empr.com/aaaai-2017/pediatric-rhinitis-asian-non-allergic-immunoglobulin-e/article/642022/

“This Asian cohort demonstrates supportive evidence for positive association of tobacco smoke exposure with rhinitis, while the effect is mainly confirmed to non-allergic rhinitis and more pronounced in adolescents than in young children, highlighting the need for raising public health awareness about the detremental effects of tobacco smoke exposure on children’s respiratory health,” reported lead study author Hui-Ju Tsai, MPH, PhD, of the National Health Research Institutes in Miaoli, Taiwan, and coauthors.

Prior research demonstrated that tobacco smoke exposure harms respiratory health but few population studies have employed cotinine as an exposure biomarker, Dr. Tsai said. And so, the research team set out to examine tobacco smoke exposure and allergic disease among Asian children.

This population based study included a total of 1,315 children aged 5–18 years, who were assessed using questionnaire instruments, and allergen-specific immunoglobulin E, and serum cotinine concentrations as biomarkers of tobacco smoke exposure.

“Serum cotinine levels were positively associated with rhinitis ever (adjusted odds ratio [AOR] 2.95, 95% CI: 1.15–7.60) and current rhinitis (AOR 2.71, 95% CI: 1.07–6.89), while the association for physician-diagnosed rhinitis approached significance (AOR 2.26, 95% CI: 0.88–5.83 [not significant]),” they reported.

No association was found for asthma or eczema, they noted. When data were stratified by patient age groups, these associations were significant only for children at least 10 years old (rhinitis ever AOR 3.34; 95% CI: 1.05–10.61; current rhinitis AOR 4.23; 95% CI: 1.28–13.97). For patient less than 10 years old, no significant association was detected.

“Stratified analyses demonstrated significant association of serum cotinine levels with current rhinitis among children without allergic sensitization (AOR 6.76, 95% CI: 1.21–37.74), but not among those with allergic sensitization,” they noted.

Global tobacco control

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Parliament adopts Standardised packaging to save lives and prevent suffering

Members of Parliament voted in favour of standardised packaging of tobacco products despite intense lobbying by the tobacco industry to sway politicians against the measure.

http://www.smokefreepartnership.eu/partner-news/item/parliament-adopts-standardised-packaging-to-save-lives-and-prevent-suffering

The snowball that was set in motion in Australia in 2012 rolled through Norway today. An overwhelming majority of Parliament endorsed recommendations formulated on 1 December 2016 by the parliamentary Standing Committee on Health and Care Services. The measure will be introduced at the same time as the EU Tobacco Products Directive measures on packaging and labelling.

Tobacco advertising is deadly. It seeks to addict people to a product that kills almost half of its long-term users. Today, Norway becomes one of the first countries in the world to introduce standardised cigarette packs and the first country to standardise smokeless tobacco boxes. Smokeless tobacco use increased dramatically among young people in Norway during the last decade. The new measure will contribute to ensure that children and young people never start with tobacco and thus avoid tobacco-related suffering and death.

Anne Lise Ryel, Secretary General of the Norwegian Cancer Society said: “Norwegian politicians have taken a historic step forward to reduce the consequences of tobacco advertising. Advertising works, especially with children. Norway was the first country in the world to introduce bans on all traditional forms of advertising of tobacco products. Ever since, cigarette packs have become mini billboards for tobacco industry marketing. With this morning’s event, the tobacco industry loses its last vehicle to lure children into addiction, disease and possibly death. This is truly a ground-breaking public health reform, and a landmark day for the cancer cause”.

The Norwegian Cancer Society congratulated Minister of Health and Care Services Bent Høie for his leadership in support of the measure in the face of persistent pressure and campaigning from the tobacco industry.

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

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National Cancer Institute – The Economics of Tobacco and Tobacco Control

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Tobacco exposure ups behavioural issues and dropout rates in children

Exposure to tobacco smoke is immensely toxic to the developing brain.

http://www.thehealthsite.com/news/tobacco-exposure-ups-behavioural-issues-and-dropout-rates-in-children-ag1116/

Children exposed to tobacco smoke in early childhood adopt anti-social behaviour, engage in proactive and reactive aggression, and face conduct problems at school, even drop out at age 12, a research has showed. Exposure to tobacco smoke is toxic to the developing brain at a time when it is most vulnerable to environment input, the researchers said. ‘Young children have little control over their exposure to household tobacco smoke, which is considered toxic to the brain at a time when its development is exponential,’ said lead author and Professor Linda Pagani from the University of Montreal in Quebec, Canada. Parents who smoke near their children often inadvertently expose them to second- and third-hand smoke. Abnormal brain development can result from chronic or transient exposure to toxic chemicals and gases in second-hand tobacco smoke. These compounds eventually solidify and create third-hand smoke. In the study, the researchers found compelling evidence that suggests other dangers to developing brain systems that govern behavioural decisions, social and emotional life as well as cognitive functioning.

Anti-social behaviour is characterised by proactive intent to harm others, lack prosocial feelings, and violate social norms. Such behaviours include aggression, criminal offences, theft, refusal to comply with authority, destruction of property and is also associated with academic problems in later childhood. ‘These long-term associations should encourage policy-makers and public health professionals to raise awareness among parents about the developmental risks of second-hand smoke exposure,’ Pagani said. For the study, published in the journal Indoor Air, the team examined 1,035 boys and girls born in 1997 and 1998. Their parents reported whether anyone smoked at home when their children were aged 1.5 to 7.5 years. At age 12, their children self-reported their anti-social behaviour and academic characteristics. (Read: Children exposed to cigarette smoke may develop early heart disease)

Smoking parents linked to severe asthma

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.”

Quebec’s new tobacco laws come into full effect Saturday

http://digital-cameras-planet.com/canadahealth/quebecs-new-tobacco-laws-come-into-full-effect-saturday/23107

Smoking outside, within a 9 metre-radius of a window or door that opens, is now prohibited in Quebec, under the Tobacco Control Act.Formerly known as the Tobacco Act, several amendments were made to the law with the first changes coming into effect one year ago today.According to a government website, the Tobacco Control Act was enacted to protect the public from the dangers of second-hand smoke, to encourage smokers to quit smoking and to prevent youth from taking up smoking to begin with.

Changes to the act targeted several areas, including but not limited to, the use of tobacco in certain places, the promotion and advertising of tobacco products, a framework for electronic cigarettes and increased fines for offences.The last amendments to the law came into effect Saturday.The nine-metre radius rule is also applicable to air intakes connected to an enclosed place where smoking is not allowed. The exception is when the radius extends beyond property limits, meaning that if a door or window leads to a municipal sidewalk the smoke ban doesn’t apply.As of Saturday, it is also illegal for adults to buy tobacco products for minors.Anyone caught contravening the act can be fined anywhere from $250 to $3,000 depending on the offence and whether or not it’s a repeat offence. Prior penalties ranged from $50 to $3,000.For a full list of regulations, fines and offences, you can consult the Quebec government’s online health portal.